Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients

Objective: This study aims to evaluate the costs and health outcome for surgical and conservative treatment of displaced proximal humeral fractures. Design: This study is a randomised controlled trial. Participants: This study included 50 patients aged 60 or older admitted to hospital with a severely displaced three-or four-part fracture. Interventions: The patients were treated surgically with an angular stable interlocking implant (25 patients) or conservative treatment (25 patients). Main outcome measure: The outcomes measured included quality-adjusted life years (QALYs) and societal costs. Results: At 12 months' follow-up, the mean difference in the number of QALYs was 0.027 (95% confidence interval (CI) = -0.025, 0.078) while the mean difference in total health-care costs was (sic)597 in favour of surgery (95% CI = -5291, 3777). Conclusion: There was no significant difference in QALYs or costs between surgical and conservative treatment of severe displaced proximal humeral fractures. (C) 2009 Elsevier Ltd. All rights reserved.