Markus Muhm1,2, Julia Bott3, Christoph Lahr4, Hartmut Winkler4,5, Thomas Ruffing4. 1. Department for Trauma and Orthopedic Surgery I, Westpfalz-Klinikum Kaiserslautern, Academic Educational Hospital, Heidelberg University and Mainz University, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany. mmuhm@westpfalz-klinikum.de. 2. Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. mmuhm@westpfalz-klinikum.de. 3. Department for Trauma and Orthopedic Surgery, Municipal Hospital, Pirmasens, Germany. 4. Department for Trauma and Orthopedic Surgery I, Westpfalz-Klinikum Kaiserslautern, Academic Educational Hospital, Heidelberg University and Mainz University, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany. 5. Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
Abstract
BACKGROUND: The proximal humeral fracture (PHF) (5 %) of the elderly is the third most common fracture after proximal femoral and distal radius fractures. Proximal femoral fractures often lead to a loss of autonomy. OBJECTIVES: The aim of this study is to show how PHF changes the patient's autonomy and the coping with everyday life as well as which factors influence the outcome 1 year (y) after surgery. MATERIALS AND METHODS: Data of 62 patients with surgical treatment of a PHF ≥ 60 y was prospectively collected. With a telephone interview Short Form (SF) 12 (physical and mental health; PH, MH), Barthel Index (BI), range of motion, pain, and satisfaction was observed after 3 and 12 months. The dependence of outcome on different factors was investigated. RESULTS: The mean age was 73.3 y (median 73, 60-94). Mortality after 3 months was 3 % and after 1 y 11 %. The PH before the injury (47.9) was significantly better than after 3 months (37.1) and after 1 y (42.6). The MH showed no difference. The BI before the injury (92) was significantly better than after 3 months (86), but the same after 1 y (91). After 1 y > 50 % were able to abduct and flex the arm > 90°. More than two-thirds were able to perform everyday life activities for body care and nutrition after 1 y. Approximately, 73 % of the patients had little or no pain, and 84 % were satisfied with the result after 1 y. Good score values before the fracture resulted in better outcome. Higher severity in fracture led to a higher level of pain. DISCUSSION: A surgically treated PHF in the elderly does not lead to a relevant impairment in quality of life. Despite the lack of complete retrieval of range of motion patients achieve a good to very good result in coping with everyday life.
BACKGROUND: The proximal humeral fracture (PHF) (5 %) of the elderly is the third most common fracture after proximal femoral and distal radius fractures. Proximal femoral fractures often lead to a loss of autonomy. OBJECTIVES: The aim of this study is to show how PHF changes the patient's autonomy and the coping with everyday life as well as which factors influence the outcome 1 year (y) after surgery. MATERIALS AND METHODS: Data of 62 patients with surgical treatment of a PHF ≥ 60 y was prospectively collected. With a telephone interview Short Form (SF) 12 (physical and mental health; PH, MH), Barthel Index (BI), range of motion, pain, and satisfaction was observed after 3 and 12 months. The dependence of outcome on different factors was investigated. RESULTS: The mean age was 73.3 y (median 73, 60-94). Mortality after 3 months was 3 % and after 1 y 11 %. The PH before the injury (47.9) was significantly better than after 3 months (37.1) and after 1 y (42.6). The MH showed no difference. The BI before the injury (92) was significantly better than after 3 months (86), but the same after 1 y (91). After 1 y > 50 % were able to abduct and flex the arm > 90°. More than two-thirds were able to perform everyday life activities for body care and nutrition after 1 y. Approximately, 73 % of the patients had little or no pain, and 84 % were satisfied with the result after 1 y. Good score values before the fracture resulted in better outcome. Higher severity in fracture led to a higher level of pain. DISCUSSION: A surgically treated PHF in the elderly does not lead to a relevant impairment in quality of life. Despite the lack of complete retrieval of range of motion patients achieve a good to very good result in coping with everyday life.
Entities:
Keywords:
Coping with everyday life; Outcome; Proximal humeral fracture; Quality of life; Satisfaction
Authors: T Einsiedel; C Becker; D Stengel; A Schmelz; M Kramer; M Däxle; F Lechner; L Kinzl; F Gebhard Journal: Z Gerontol Geriatr Date: 2006-12 Impact factor: 1.281