Centre for Evidence-Based Orthopaedics, Department of Orthopaedic Surgery, Zealand University Hospital, Køge; Department of Clinical Medicine, University of Copenhagen, Denmark.
Centre for Evidence-Based Orthopaedics, Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark.
Acta Orthop. 2024 Nov 5;95:619-624. doi: 10.2340/17453674.2024.42301.
Neer 2-part surgical neck fractures are the most common displaced proximal humerus fractures. We aimed to evaluate patient-reported outcome in a consecutive series of older people receiving nonoperative treatment.
This is a single-center prospective cohort study. We included patients aged 60 or above referred to a Danish university hospital. The preregistered protocol followed the recommendations from randomized trials. Patients were followed at the outpatient clinic at 2, 6, and 24 weeks. After 24 weeks, they were evaluated with Oxford Shoulder Score (OSS, 0-48, 48 best) and EuroQoL 5 dimensions, 3 levels (EQ-5D-3L, -0.624 to 1, 1 best). Clinical failure was defined as conversion to surgery or OSS ≤ 24. Population norms were reported to interpret the cohort data, but no formal statistical comparisons between historical cohorts were planned. We used descriptive statistics to report rates and proportions.
For 36 months, 268 patients (mean age 76, 79% female) with Neer 2-part surgical neck fractures received non-surgical treatment. After excluding patients with concomitant fractures, dementia, or death, complete follow-up was available for 167 patients. 8 patients (3.0%) had surgery. The mean OSS was 37.2 (SD 8.1), which equals 78% of maximum shoulder function. The norm for the population of the same age and gender was 82%. The mean EQ-5D-3L score was 0.79 (SD 0.16), while the norm for the same-age population was 0.82. 16 (10%) had an OSS score of 24 or below.
Non-surgical treatment in older people with Neer 2-part surgical neck fractures resulted after 6 months in patient-reported shoulder function and quality of life close to that of the Danish background population.
Neer 2 部分外科颈骨折是最常见的移位肱骨近端骨折。我们旨在评估连续系列老年患者接受非手术治疗后的患者报告结果。
这是一项单中心前瞻性队列研究。我们纳入了年龄在 60 岁及以上并转诊至丹麦大学医院的患者。该预注册方案遵循随机试验的建议。患者在门诊接受 2、6 和 24 周的随访。24 周后，使用牛津肩评分（OSS，0-48，48 为最佳）和欧洲五维健康量表 3 级（EQ-5D-3L，-0.624 到 1，1 为最佳）进行评估。临床失败定义为转为手术或 OSS≤24。报告人群正常值以解释队列数据，但未计划对历史队列进行正式的统计比较。我们使用描述性统计来报告率和比例。
在 36 个月内，268 名（平均年龄 76 岁，79%为女性）Neer 2 部分外科颈骨折患者接受了非手术治疗。排除伴有骨折、痴呆或死亡的患者后，167 名患者可获得完整随访。8 名患者（3.0%）接受了手术。平均 OSS 为 37.2（SD 8.1），相当于最大肩部功能的 78%。同年龄和性别人群的正常值为 82%。平均 EQ-5D-3L 评分为 0.79（SD 0.16），而同年龄人群的正常值为 0.82。16 名患者（10%）OSS 评分在 24 分或以下。
6 个月后，老年 Neer 2 部分外科颈骨折患者接受非手术治疗后，患者报告的肩部功能和生活质量接近丹麦背景人群。
