5-Year Mortality After Complex Displaced Proximal Humerus Fractures in Elderly Patients: Conservative Versus Reverse Total Shoulder Arthroplasty

<b>Background:</b> The mortality rate following proximal humerus fractures (PHFs) in elderly patients is increased, but currently, there are no medium-term studies comparing mortality following treatment with Reverse Total Shoulder Arthroplasty (RTSA) to non-surgical treatment. <b>Methods:</b> This retrospective study compares two groups of elderly patients (aged 75 to 95 at the time of injury) who were diagnosed with PHFs. A total of 79 patients (mean age: 83.1 ± 4.6) were treated conservatively between 2008 and 2010, a time when RTSA was not yet considered a treatment option, and 81 patients (mean age: 82.4 ± 4.4) underwent RTSA between 2012 and 2017. Also, 1-month, 1-year, and 5-year mortality rates were recorded. <b>Results:</b> The 1-month, 1-year, and 5-year mortality rates were 1.2%, 7.4%, and 33.3% in the RTSA group and 2.5%, 11.4%, and 38.0% in the non-surgical treatment group (<i>p</i> = 0.98, <i>p</i> = 0.55, <i>p</i> = 0.65). A subgroup analysis revealed that the mild difference between groups can be attributed to male patients only. <b>Conclusions:</b> This study explored the impact of RTSA versus non-surgical treatment on mortality in elderly patients with PHFs and found similar mortality rates over five years. Better segmentation of the patient population may reveal subgroups with different mortality patterns.