Displaced Proximal Humerus Fractures in Older Patients: Shoulder Surgeons Versus Traumatologists

• DOI: 10.3928/01477447-20160427-08
• Publication Date: 2016-05-02T15:45:27Z
• Authors: Suneel B. Bhat; Eric S. Secrist; Luke S. Austin; Charles L. Getz; James C. Krieg; Samir Mehta; Surena Namdari
• Keywords: Male; Surgeons; Humerus; Arthroplasty; 3. Good health; Fracture Fixation, Internal; 03 medical and health sciences; Orthopedics; 0302 clinical medicine; Traumatology; Surveys and Questionnaires; Shoulder Fractures; Humans; Female; Tomography, X-Ray Computed; Aged

Proximal humerus fractures are relatively common, with treatment dependent on fracture-specific, patient-specific, and surgeon-specific factors. This study sought to identify preferences among shoulder specialists orthopedic traumatologists in the of proximal fractures. An anonymous Internet survey fellowship-trained surgeons was conducted radiographs select computed tomography images 15 unique displaced Participants were asked classify each case according Neer criteria choose management from a list options. Groups analyzed using chi-square test for independence, paired t test, Fleiss' kappa within between group. Among surgeons, there total 19 cases selected nonoperative management, 204 open reduction internal fixation (ORIF), 122 arthroplasty. traumatologists, 44 234 ORIF, 67 intraobserver agreement choice 0.26 0.18 independence significant 2 groups ( P <.001). Paired average proportions arthroplasty =.003) but not differences rates ORIF. These results confirm poor consistency classification suggest that more likely consider use ORIF or manage patients nonoperatively. variations care may translate outcome cost. [ Orthopedics. 2016; 39(3):e509–e513.]