Functional Outcome after Treatment of Three-Part Proximal Humerus Fractures Using Locking Plate vs. Conservative Treatment in the Elderly

Abstract Background Proximal humeral fractures (PHFs) are among the most common fractures in the elderly. The majority of proximal humeral fractures are treated conservatively, and up to 33% are treated surgically. Objective To compare functional outcome and quality of life after treatment of displaced 3-part proximal humerus fractures using the locking plates, as compared to nonoperative treatment in elderly patients. Methods This study performed a search for all published articles locking plates or nonoperative treatment in the management of displaced 3-part proximal humerus fractures. Results The pooled analysis of the included studies showed no significant difference between conservative treatment and operative treatment regarding the outcome of Constant score (MD = 0.04; 95% CI:[-0.2, 0.29]; P = 0.748). The pooled analysis of the included studies showed no significant difference in postoperative the DASH score between conservative treatment and operative treatment (MD = 0.05; 95% CI:[-0.35, 0.25]; P = 0.48). The pooled analysis of the included studies showed no significant difference in the outcome of VAS score between conservative treatment and operative treatment (MD = 0.38; 95% CI:[0.07, 0.69]; P = 0.748). The pooled analysis of the included studies showed no significant difference in ROM between conservative treatment and operative treatment (MD = 0.39; 95% CI:[-0.15, 0.94]; P = 0.425). The pooled analysis of the included studies showed no significant difference in postoperative complications between conservative treatment and operative treatment (RR = 1.148; 95% CI:[0.369 3.575]; P = 0.507). The pooled analysis of the included studies showed no significant difference in the outcome of non-union rate between conservative treatment and operative treatment (RR = 0.85; 95% CI: [0.72 – 2.28]; P = 0.158). Conclusion The results of this meta-analysis revealed no significant differences between conservative treatment and operative treatment as regard constant scores, DASH and VAS scores, range of movement, incidence of complications or non-union.