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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2022, Number 1

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Acta Ortop Mex 2022; 36 (1)

Direct medical cost of late rehabilitation in workers with conservatively managed proximal humerus fracture

Navarrete-Peñaloza B, Hernández-Amaro H
Full text How to cite this article 10.35366/106754

DOI

DOI: 10.35366/106754
URL: https://dx.doi.org/10.35366/106754

Language: Spanish
References: 14
Page: 14-19
PDF size: 130.21 Kb.


Key words:

Rehabilitation, late, fractures, proximal humerus, cost.

ABSTRACT

Introduction: Eighty percent of the Proximal humerus fractures are not displaced or minimally displaced and stable. The international treatment recommendation is conservative. Immobilization of the limb carries risk of stiffness, pain and decreased function. Currently being used rehabilitation programs with early mobilization of the injured shoulder within the first week post-fracture, with evidence of early functional and labor recovery and with no risk for displacement of fragments. However, in our country, these patients start rehabilitation late, which leads to a delay in the recovery of functionality and delay in returning to work, translating into increased costs. At the moment there is no national benchmark for the cost of this late-onset rehabilitation. Material and methods: From a non-probabilistic sample for convenience, were analyzed records of 52 patients, treated in the period from January to December 2019. Inclusion criteria were workers diagnosed with a proximal humeral fracture, conservative management; exclusion criteria were peripheral nerve injury, aggregate fracture or surgically treated. Results: The mean direct medical cost was $19,090.69 Mexican pesos, directly proportional to the days of stay in the unit and disability. Conclusion: Late rehabilitation leads to more days of disability than recommended by the based guidelinesin the workload, therefore, higher cost.


REFERENCES

  1. Núñez-Gómez, DA, Hernández-Álvarez, B, Pérez-Atanasio, JM, Torres-González, R, Águila-Ledesma IR. Patrón de tratamiento en pacientes adultos mayores con fractura de húmero proximal en tres o cuatro fragmentos en un centro de referencia de una economía emergente. Acta Ortop Mex. 2015; 29(4): 207-11.

  2. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006; 37: 691-7.

  3. Launonen AP, Lepola V, Saranko A. Epidemiology of proximal humerus fractures. Arch Osteoporos. 2015; 10: 209.

  4. Handoll HH, Brorson S. Interventions for treating proximal humeral fractures in adults. Cochrane Database Syst Rev. 2015; (11): CD000434.

  5. Launonen AP, Lepola V, Flinkkila T, Laitinen M, Paavola M, Malmivaara A. Treatment of proximal humerus fractures in the elderly: a systemic review of 409 patients. Acta Orthop. 2015; 86(3): 280-5.

  6. Handoll H, Brealey S, Rangan A, Keding A, Corbacho B, Jefferson L, et al. The ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation) trial - a pragmatic multicentre randomised controlled trial evaluating the clinical effectiveness and cost-effectiveness of surgical compared with non-surgical treatment for proximal fracture of the humerus in adults. Health Technol Assess. 2015; 19(24): 1-280.

  7. Hodgson S. Proximal humerus fracture rehabilitation. Clin Orthop Relat Res. 2006; 442: 131-8.

  8. Lungberg BJ, Svenungson-Hartwig E, Wikmark R. Independent exercises versus physiotherapy in nondisplaced proximal humeral fractures. Scand J Rehabil Med. 1979; 11(3): 133-6.

  9. Bertoft ES, Lundh I, Ringqvist I. Physiotherapy after fracture of the proximal end of the humerus. Comparison between two methods. Scand J Rehabil Med. 1984; 16(1): 11-6.

  10. Aguado HJ, Ariño B, Moreno-mateo F, Bustinza EY, Simón-pérez C, Martínez-Zarzuela M, et al. Does an early mobilization and immediate home- based self-therapy exercise program displace proximal humeral fractures in conservative treatment? Observational study. J Shoulder Elb Surg. 2018; 27 (11): 2021-9. Available in: https://doi.org/10.1016/j.jse.2018.04.001

  11. Lefevre-Colau MM, Babinet A, Fayad F, Fermanian J, Anract P, Roren A, et al. Immediate mobilization compared with conventional immobilization for the impacted nonoperatively treated proximal humeral fracture. A randomized controlled trial. J Bone Joint Surg Am. 2007; 89(12): 2582-90.

  12. Bruder AM, Shields N, Dodd KJ, Taylor NF. Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. J Physiother. 2017; 63(4): 205-20. Available in: http://dx.doi.org/10.1016/j.jphys.2017.08.009

  13. Carbone S, Razzano C, Albino P, Mezzoprete R. Immediate intensive mobilization compared with immediate conventional mobilization for the impacted osteoporotic conservatively treated proximal humeral fracture: a randomized controlled trial. Musculoskelet Surg. 2017; 101(Suppl 2): 137-43.

  14. Frank FA, Niehaus R, Borbas P, Eid K. Risk factors for secondary displacement in conservatively treated proximal humeral fractures. Bone Joint J. 2020; 102-B(7): 881-9.



EVIDENCE LEVEL

IV




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Acta Ortop Mex. 2022 Ene-Feb;36