Treatment of Proximal Humerus Fractures in the Elderly (prox_hum)
Treatment Options for Proximal Humerus Fractures in the Elderly and Their Implication on Personal Independence
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
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Basel-Stadt
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Basel, Basel-Stadt, Switzerland, 4021
- University Hospital Basel
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age of 65 years or above
- Proximal humerus fracture
- Informed consent by the patient or legal representatives to participate in the study
Exclusion Criteria:
- More than one fracture, polytrauma
- Suspicion of a pathological fracture in the context of known or unknown malignancy
- Previous surgery of the proximal humerus on the same side
- High energy trauma
- Open Fracture
- Insufficient German language skills
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
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experimental intervention
A greater degree of initial displacement is tolerated to allow for conservative, non-operative treatment in more simple fracture patterns.
Two-part fractures with marked displacement including two part patterns with a non-displaced greater or minor tuberosity fracture (formally three part fractures) are treated with a proximal humerus nail; and displaced three and four part fractures are primarily managed with a reverse total shoulder arthroplasty.
Proximal Humeral Internal Locking System (PHILOS)-plates are only used exceptionally in this group of patients.
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The new treatment algorithm was applied to all patients with proximal humerus fracture as from May 2013 onwards
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control intervention
Since May 2013 we have changed our treatment algorithm for the treatment of fractures of the humeral head in the elderly. Before this change in algorithm we used PHILOS plates extensively and rarely Inverse Shoulder prostheses. In general all proximal humerus fractures were operated except minimally or undisplaced. |
The old treatment algorithm was applied to all patients with proximal humerus fracture up to May 2013.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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personal dependency status
Time Frame: 6 months
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A simple four point rating is used at the time of injury (for the premorbid state) and at 6 months to demonstrate the impact of the injury (including its treatment) on the ability to return to the former social environment and degree of self-dependency.
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6 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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range of motion
Time Frame: 6 months
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6 months
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Shoulder pain and disability index (SPADI)
Time Frame: 6 months
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The SPADI is a patient-based questionnaire containing 15 questions about pain and activities of daily living that must be answered by the patient on a scale of 0-10 (0 = no pain / no difficulties to 10 = Worst pain / activity).
Five questions relate to the pain and 8 questions relate to the function in daily activities, both subscores are combined and converted to the total score to 0 (= lowest score) to 100 (= best result).
A validated German version is available
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6 months
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SSV
Time Frame: 6 months
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The Subjective Shoulder Value (SSV) is based on a single question that is answered subjectively by the patients.
The English formulation of this question is: "What is the overall percent value of your shoulder if a completely normal shoulder represents 100%?" 12 It is an easily administered measure of shoulder function.
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6 months
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General health using EuroQuality of life (EQ)-5D-5L visual analogue scale (VAS)
Time Frame: 6 months
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The gain in quality of life within two years after surgery is assessed using the generic Quality of Life (QoL) EuroQoL EQ-5D-5L instrument.
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6 months
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Quality of life (utilities) derived using EQ-5D-5L
Time Frame: 6 months
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Using the EQ-5D-5L instrument patients are asked to report on their general health status on a VAS scale from 0 (worst possible health) to 100 (best possible health).
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6 months
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Daniel Rikli, Prof, University Hospital, Basel, Switzerland
Publications and helpful links
General Publications
- Schurch MA, Rizzoli R, Mermillod B, Vasey H, Michel JP, Bonjour JP. A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res. 1996 Dec;11(12):1935-42. doi: 10.1002/jbmr.5650111215.
- Rikli D, Feissli S, Muller AM, Steinitz A, Suhm N, Jakob M, Audige L. High rate of maintaining self-dependence and low complication rate with a new treatment algorithm for proximal humeral fractures in the elderly population. J Shoulder Elbow Surg. 2020 Jun;29(6):1127-1135. doi: 10.1016/j.jse.2019.11.006. Epub 2020 Feb 10.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2014-310
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