Ott Nadine, Müller Carolin, Jacobs Andreas, Paul Christian, Wegmann Kilian, Müller Lars Peter, Kabir Koroush
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery.
University of Bonn, Faculty of Medicine and University Hospital, Department of Orthopedic and Trauma Surgery.
OTA Int. 2022 Apr 18;5(2 Suppl):e188. doi: 10.1097/OI9.0000000000000188. eCollection 2022 Apr.
In view of the increased attention to reverse shoulder arthroplasty (rTSA) as a treatment for complex proximal humeral fractures in the elderly, the present study analyzes in-hospital complications and the postoperative management of rTSA versus open reduction and internal fixation (ORIF).
We retrospectively reviewed patients hospitalized from 2016 to 2018 for proximal humeral fractures (ICD-9 codes: S42.21), III- and IV-part, who underwent an ORIF with locking plates, rTSA or nonoperative treatment. In-hospital complications and postoperative management in both groups were included in the analysis.
We included n 190 patients (ORIF 90, rTSA 71, nonoperative 29), more likely to be female (82.1% vs 17.9%; .01) with an average age of 82years (min. 72, max. 99; SD 6.4). The ORIF and the rTSA groups showed comparable complication rates (15.6% vs 15%, .87) but with a significantly shorter hospital stay (8.6 vs 11.5days; .01) and shorter duration of surgery (72.9 vs 87.2 minutes; .01) in the ORIF group. Significantly more patients after ORIF achieved an independent life postoperatively (53.3% vs 40.8%; .013).
In this retrospective analysis, ORIF is related to a shorter duration of surgery, a shorter hospital stay and a higher likelihood of independence. Despite the popularity of the rTSA, ORIF remains a reliable treatment option for proximal humeral fractures in the elderly.Level of evidence: III.
鉴于作为老年复杂肱骨近端骨折治疗方法的反肩关节置换术（rTSA）受到越来越多的关注，本研究分析了rTSA与切开复位内固定术（ORIF）的院内并发症及术后管理。
我们回顾性分析了2016年至2018年因肱骨近端骨折（ICD-9编码：S42.21）、三部分和四部分骨折而住院，并接受锁定钢板切开复位内固定术、rTSA或非手术治疗的患者。分析两组的院内并发症及术后管理情况。
我们纳入了190例患者（切开复位内固定术组90例，rTSA组71例，非手术组29例），女性患者居多（82.1%对17.9%；P<0.01），平均年龄82岁（最小72岁，最大99岁；标准差6.4）。切开复位内固定术组和rTSA组的并发症发生率相当（15.6%对15%；P=0.87），但切开复位内固定术组的住院时间明显更短（8.6天对11.5天；P<0.01），手术时间更短（72.9分钟对87.2分钟；P<0.01）。切开复位内固定术后更多患者术后实现了独立生活（53.3%对40.
