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Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients
Fjalestad T, Hole MO, Jorgensen JJ, Stromsoe K, Kristiansen IS
Injury 2010 Jun;41(6):599-605
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study aims to evaluate the costs and health outcome for surgical and conservative treatment of displaced proximal humeral fractures. DESIGN: This study is a randomised controlled trial. PARTICIPANTS: This study included 50 patients aged 60 or older admitted to hospital with a severely displaced three- or four-part fracture. INTERVENTIONS: The patients were treated surgically with an angular stable interlocking implant (25 patients) or conservative treatment (25 patients). MAIN OUTCOME MEASURE: The outcomes measured included quality-adjusted life years (QALYs) and societal costs. RESULTS: At 12 months' follow-up, the mean difference in the number of QALYs was 0.027 (95% confidence interval (CI) -0.025 to 0.078) while the mean difference in total health-care costs was Euro 597 in favour of surgery (95% CI -5,291 to 3,777). CONCLUSION: There was no significant difference in QALYs or costs between surgical and conservative treatment of severe displaced proximal humeral fractures.
With permission from Excerpta Medica Inc.

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