Key result
There remains little compelling evidence to guide decision-making for complex proximal humeral fractures in the elderly, requiring decisions to be made on a case-by-case basis.
Why the study?
Recent evidence questions surgical intervention, and little compelling evidence remains to guide decision-making for complex proximal humeral fractures in the elderly.
Does open reduction and internal fixation improve outcomes in elderly patients with complex proximal humeral fractures?
Does open reduction and internal fixation improve outcomes in elderly patients with complex proximal humeral fractures?
Current evidence does not strongly support surgical intervention over conservative management for complex proximal humerus fractures in the elderly, necessitating individualized treatment decisions.
Insufficient evidence guides proximal humeral fracture care in the elderly; leaves open optimal surgical versus conservative strategies.
The ultimate goal of management of proximal humeral fractures in the elderly patient is to get the patient independently mobile.This article will review the current literature regarding this cohort of patient.Recent Cochrane reviews and a large multicentre randomised study question the role of surgical intervention.Implant design is evolving rapidly, and many elderly patients now behave more like the younger patient.There remains little compelling evidence to guide decision-making for the complex proximal humeral fracture in the elderly, and the decision needs to be made on a case-by-case basis taking into account the patient's comorbidities, the fracture pattern and characteristics, the attending surgeon's skill sets, and the availability of equipment.
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Bernstein et al. (2019) conducted a review in Complex proximal humerus fractures in the elderly. Open reduction and internal fixation (surgical intervention) was evaluated. There remains little compelling evidence to guide decision-making for complex proximal humeral fractures in the elderly, requiring decisions to be made on a case-by-case basis.
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