Satisfactory Functional Outcomes Can Be Achieved with Conservative Treatment of Proximal Humerus Fractures in the Elderly

Objective: Although surgical treatment is the preferred option for fractures affecting joints and requiring early movement, conservative treatment represents a viable alternative for individuals unsuitable for surgery due to the increased risks of comorbidities associated with advanced age.The objective of this study was to analyze the clinical functional results and patient satisfaction of proximal humerus fractures (PHFs) that were followed conservatively in our clinic.Methods: This single-center, retrospective, observational study investigated 48 elderly patients treated conservatively for PHFs.The following variables were investigated: age, gender, fracture side, and Neer classification.The American Shoulder and Elbow Surgeons Shoulder Score (ASES), which provides information about pain level and functional results, was determined and analyzed at the last outpatient clinic control.Furthermore, a subjective satisfaction scale was devised, comprising a 5-point scale (from 1-completely unsatisfied to 5-completely satisfied) for the assessment of patient satisfaction. Results:The median age was 77.5 years (range: 65-97).The median total ASES scores were 76.6 (range: 45-96.6).A total of 68.8% of the patients were satisfied from the treatment.A significant difference was identified between fracture type and total ASES scores at the final follow-up (P = .038)(Table 2).Subsequent post-hoc analyses revealed a significant distinction in total ASES scores between type 2 and type 4 fractures (P = .012). Conclusion:Our findings suggest that geriatric patients with PHFs can achieve favorable results through the implementation of an appropriate conservative treatment plan.As expected, an increase in fragmentation levels has been linked to a decline in clinical outcomes.