Surgery with locking plate or hemiarthroplasty versus nonoperative treatment of 3–4-part proximal humerus fractures in older patients (NITEP): An open-label randomized trial

Proximal humerus fractures (PHFs) are common fractures, especially in older female patients. These fractures are commonly treated surgically, but the consensus on the best treatment is still lacking. The primary aim of this multicenter, randomized 3-arm superiority, open-label trial was to assess th...

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Published in:PLoS medicine Vol. 20; no. 11; p. e1004308
Main Authors: Launonen, Antti P., Sumrein, Bakir O., Reito, Aleksi, Lepola, Vesa, Paloneva, Juha, Berg, Hans E., Felländer-Tsai, Li, Kask, Kristo, Rahnel, Timo, Tootsi, Kaspar, Märtson, Aare, Jonsson, Kenneth B., Wolf, Olof, Ström, Peter, Døssing, Kaj, Østergaard, Helle K., Mechlenburg, Inger, Mattila, Ville M., Laitinen, Minna K.
Format: Journal Article
Language:English
Published: San Francisco Public Library of Science 28.11.2023
Public Library of Science (PLoS)
Subjects:
Aged patients
Analysis
Arm
Arthroplasty
Biology and Life Sciences
Care and treatment
Clinical trials
Comparative analysis
Complications and side effects
Consent
Ethics
Fractures
Hospitals
Humerus
Injuries
Internal fixation in fractures
Medical research
Medicine and Health Sciences
Methods
Orthopedics
Patients
Questionnaires
Research and Analysis Methods
Surgery
Trauma
Scandinavia
Sweden
Finland
Estonia
ISSN:1549-1676, 1549-1277, 1549-1676
Online Access:Get full text
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Summary:Proximal humerus fractures (PHFs) are common fractures, especially in older female patients. These fractures are commonly treated surgically, but the consensus on the best treatment is still lacking. The primary aim of this multicenter, randomized 3-arm superiority, open-label trial was to assess the results of nonoperative treatment and operative treatment either with locking plate (LP) or hemiarthroplasty (HA) of 3- and 4-part PHF with the primary outcome of Disabilities of the Arm, Shoulder, and Hand (DASH) at 2-year follow-up. In this study, no benefit was observed between operative treatment with LP or HA and nonoperative treatment in displaced 3- and 4-part PHFs in patients aged 60 years and older. Further, we observed a high rate of complications related to operative treatments.
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The authors have declared that no competing interests exist.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1004308