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National trends in proximal humerus fracture treatment patterns

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Abstract

Background

The treatment of proximal humerus fractures (PHF) is largely surgeon dependent with no clear guidelines for selecting the optimal method of treatment.

Aims

The aim of this study was to evaluate trends and variations in treatment methods of PHF in the United States from 2004 to 2012 and to determine the regional differences in treatment.

Methods

The National Inpatient Sample was used to identify all patient discharges with diagnosis codes for PHF and the data were classified based on ICD-9 procedure codes. Patient and hospital demographics were also analyzed. Simple linear regression analyses were performed for each treatment modality to evaluate current treatment trends and to extrapolate the future trends of PHF treatment over the next 20 years.

Results

A national estimate of 550,116 PHF discharges was identified over the time period. Significant correlations between change over time and treatment modality were found for reverse shoulder arthroplasty (RSA) (r = 0.903, p < 0.001), open reduction internal fixation (r = 0.876, p = 0.002), and closed reduction internal fixation (r = −0.922, p < 0.001). The RSA regression model showed that by the year 2032, PHF treated with RSA will increase 100% from 2012.

Discussion

There were significant changes in treatment modalities for PHF from 2004 to 2012; The projected number of RSA used to treat PHF will be about 9115 in 2032, compared to 340 in 2004.

Conclusion

Overall, there was a growth in proximal humerus fractures treated in an inpatient setting in the United States. RSA had the greatest proportional increase over time, but only accounted for less than 2% of total interventions.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Wayne State University/Oakwood, 10000 Telegraph Road, Taylor, MI, 48180, USA

    Vani J. Sabesan, Daniel Lombardo, Graysen Petersen-Fitts & Martin Weisman

  2. Wayne State University School of Medicine, 540 East Canfield Street, Detroit, MI, 48201, USA

    Kyle Ramthun & James Whaley

Authors
  1. Vani J. Sabesan
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Correspondence to Vani J. Sabesan.

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Conflict of interest

Author Vani Sabesan is a paid consultant for Arthrex, Inc., and has received research support from Exactech, Inc. On behalf of all other authors, the corresponding author states that there is no conflict of interest.

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All authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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This article does not contain any studies with human participants performed by any of the authors.

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Sabesan, V.J., Lombardo, D., Petersen-Fitts, G. et al. National trends in proximal humerus fracture treatment patterns. Aging Clin Exp Res 29, 1277–1283 (2017). https://doi.org/10.1007/s40520-016-0695-2

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