Changing trends in the management of proximal humerus fractures in New York State

Michael J Sayegh; Ryan A Nixon; Dean C Perfetti; Steven E Rokito; Nicholas A Sgaglione

doi:10.1016/j.jor.2020.03.001

Changing trends in the management of proximal humerus fractures in New York State

J Orthop. 2020 Mar 25:21:127-130. doi: 10.1016/j.jor.2020.03.001. eCollection 2020 Sep-Oct.

Authors

Michael J Sayegh¹, Ryan A Nixon¹, Dean C Perfetti¹, Steven E Rokito¹, Nicholas A Sgaglione¹

Affiliation

¹ Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.

Abstract

Purpose: Reverse shoulder arthroplasty (RSA) as an alternative to hemiarthroplasty (HA) as treatment for proximal humerus fractures has prompted a re-evaluation of utilization trends.

Methods: Operative treatment for proximal humeral fractures were analyzed using a New York State database.

Results: After introduction as an ICD-9 code, RSA increased to 39.3% (m = +5.2%/year, r = 0.984). When stratifying by age ≥65, HA decreased to 7.7% (m = -2.8%/year, r = 0.962) while RSA increased to 50.6% (m = +6.4%/year, r = 0.985).

Conclusion: RSA overtook HA as the arthroplasty procedure of choice for proximal humerus fractures. In patients ≥65, RSA passed ORIF as the most prevalent procedure in 2017.

Level of evidence: III, Descriptive Epidemiology Study, Large Database Analysis.

Keywords: Elderly; Open reduction and internal fixation; Proximal humerus fractures; Reverse shoulder arthroplasty; Shoulder hemiarthroplasty; Trauma.