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

ObjectiveThis study aims to evaluate the costs and health outcome for surgical and conservative treatment of displaced proximal humeral fractures.DesignThis study is a randomised controlled trial.ParticipantsThis study included 50 patients aged 60 or older admitted to hospital with a severely displaced three- or four-part fracture.InterventionsThe patients were treated surgically with an angular stable interlocking implant (25 patients) or conservative treatment (25 patients).Main outcome measureThe outcomes measured included quality-adjusted life years (QALYs) and societal costs.ResultsAt 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 €597 in favour of surgery (95% CI = −5291, 3777).ConclusionThere was no significant difference in QALYs or costs between surgical and conservative treatment of severe displaced proximal humeral fractures.