Treatment of Displaced Proximal Humeral Fractures in Elderly Patients

................................................................................................................................... 3 LIST OF PUBLICATIONS ............................................................................................................ 4 LIST OF ABBREVIATIONS ......................................................................................................... 5 INTRODUCTION........................................................................................................................... 6 HISTORICAL BACKGROUND ........................................................................................................ 6 EPIDEMIOLOGY ........................................................................................................................... 7 CLASSIFICATION ......................................................................................................................... 7 TREATMENT ................................................................................................................................ 9 QUALITY OF LIFE ....................................................................................................................... 10 CURRENT EVIDENCE ................................................................................................................. 12 AIMS OF THE STUDIES ............................................................................................................ 13 PATIENTS .................................................................................................................................... 14 ETHICS ....................................................................................................................................... 14 INCLUSION CRITERIA AND FOLLOW-UP .................................................................................... 14 METHODS .................................................................................................................................... 16 AGE AND GENDER ..................................................................................................................... 16 RANDOMIZATION ...................................................................................................................... 16 FRACTURE CLASSIFICATION ..................................................................................................... 16 ANAESTHESIOLOGICAL ASSESSMENT ...................................................................................... 16 COGNITIVE FUNCTION ............................................................................................................... 16 ADL ............................................................................................................................................ 17 LIVING CONDITIONS .................................................................................................................. 17 DUAL X-RAY ABSORPTIOMETRY .............................................................................................. 17 RANGE OF MOTION .................................................................................................................... 17 PAIN ........................................................................................................................................... 17 CONSTANT SCORE ..................................................................................................................... 18 DASH SCORE ............................................................................................................................ 18 QUALITY OF LIFE ....................................................................................................................... 18 ASSESSMENT OF OUTCOME ....................................................................................................... 19 RESPONSIVENESS ...................................................................................................................... 19 TREATMENT MODALITIES ........................................................................................................ 20 RADIOLOGICAL ASSESSMENT ................................................................................................... 22 STATISTICAL METHODS ............................................................................................................ 23 RESULTS ...................................................................................................................................... 24 STUDY I ..................................................................................................................................... 24 STUDY II .................................................................................................................................... 27 STUDY III ................................................................................................................................... 31 STUDY IV .................................................................................................................................. 34 GENERAL DISCUSSION ........................................................................................................... 36 THE LOCKING PLATE IN 2-PART FRACTURES ............................................................................ 36