Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients

Abstract

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, 0.078) while the mean difference in total health-care costs was 597 euro in favour of surgery (95% CI=-5291, 3777).

Conclusion: There was no significant difference in QALYs or costs between surgical and conservative treatment of severe displaced proximal humeral fractures.