Klute Lisa, Pfeifer Christian, Berner Arne, Alt Volker, Kerschbaum Maximilian, Henssler Leopold
University Hospital Regensburg, Regensburg, Germany.
Clinic of Trauma and Hand Surgery, Altötting, Germany.
Eur J Orthop Surg Traumatol. 2025 Apr 29;35(1):174. doi: 10.1007/s00590-025-04290-9.
This study aimed to assess the long-term outcomes of patients treated with plate osteosynthesis versus non-operative treatment for proximal humerus fractures (PHF) after a mean follow-up period of 10 years.
A retrospective cohort study was conducted, including patients with PHF treated between 2004 and 2014. Patients were divided into two groups: those who underwent plate osteosynthesis (PO) and those managed non-surgically (NO). Functional outcomes, including range of motion, strength, and patient-reported quality of life were evaluated using standardized assessments such as the Constant-Murley score and Short-Form-36 (SF-36) questionnaire.
A total of 241 patients (161 in the Surgical Group and 80 in the Non-Operative Group) were included in the study. With a mean follow-up of 10.4 ± 3.1 years, both groups demonstrated comparable functional outcomes. The Constant-Murley score in the Surgical Group was 53.5 ± 21.8 compared to 60.1 ± 24.2 in the Non-Operative Group (p = 0.225). Complication rates were significantly higher in the PO group. The revision rate for patients treated with plate osteosynthesis was 37.9%. Patient-reported Quality of Life, assessed using the SF-12 questionnaire, revealed no significant differences between the Surgical and Non-Operative Groups.
This long-term follow-up study demonstrates that after a minimum of 5 years, there were no significant differences in functional outcomes or quality of life between patients treated with plate osteosynthesis and those who were managed non-operatively for displaced proximal humerus fractures. Both treatment approaches can offer favorable results, and the choice of treatment should consider individual patient characteristics and preferences.
本研究旨在评估平均随访10年后，采用钢板内固定术与非手术治疗肱骨近端骨折（PHF）患者的长期疗效。
进行一项回顾性队列研究，纳入2004年至2014年间接受治疗的PHF患者。患者分为两组：接受钢板内固定术（PO）的患者和非手术治疗（NO）的患者。使用标准化评估方法，如Constant-Murley评分和简明健康调查问卷（SF-36），评估功能结局，包括活动范围、力量和患者报告的生活质量。
本研究共纳入241例患者（手术组161例，非手术组80例）。平均随访10.4±3.1年，两组的功能结局相当。手术组的Constant-Murley评分为53.5±21.8，而非手术组为60.1±24.2（p = 0.225）。PO组的并发症发生率显著更高。接受钢板内固定术治疗患者的翻修率为37.9%。使用SF-12问卷评估的患者报告生活质量显示，手术组和非手术组之间无显著差异。
这项长期随访研究表明，至少5年后，钢板内固定术治疗的患者与非手术治疗的移位肱骨近端骨折患者在功能结局或生活质量方面无显著差异。两种治疗方法均可取得良好效果，治疗方法的选择应考虑患者的个体特征和偏好。
