Published: 07-08-2019 09:37 | Updated: 07-08-2019 11:48

Non-operative treatment of displaced proximal humerus fractures yields corresponding results to surgery and can save costs.

New study published in PLOS Medicine.

The results of a recent Nordic collaboration study showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures. In the study, only fractures with a significant displacement between bone fragments were included. Patients were randomized to operative treatment using a metal plate and screws or non-operative treatment with a collar and cuff sling for three weeks apart from instructed physiotherapy.

The findings of the study are novel and challenge current treatment protocols. The result had a positive impact on both the lives of the patients as well as on the economic cost of treatment.

Proximal humerus fractures are more common in older persons than in younger adults. This fracture usually occurs as a result of falling, usually at home, directly on to the shoulder. In the proximal humerus, the bone is more fragile than in the lower arm. The healing potential in the proximal humerus is, however, better than lower in the forearm. 

This randomized controlled trial included 88 patients who were followed for two years, and was conducted as a multinational, multicenter study in six trauma centers. The leading center was Tampere University Hospital, Finland. Other centers included Jyväskylä Central Hospital in Finland, Karolinska University Hospital, Stockholm and Uppsala University Hospital in Sweden, Viborg Hospital in Denmark, and Tartu University Hospital in Estonia.

The results of this trial have been published in PLOS Medicine.

Professor Ville Mattila, MD, PhD.
Tampere University and Karolinska Institutet, CLINTEC,
Division of Orthopaedics and Biotechnology

Professor Li Felländer-Tsai, MD, PhD
Karolinska Institutet, CLINTEC,
Division of Orthopaedics and Biotechnology

Associate professor Hans Berg, MD, PhD
Karolinska University Hospital and Karolinska Institutet, CLINTEC,
Division of Orthopaedics and Biotechnology 


Li Felländer-Tsai Professor/Senior Physician