Effect of Rehabilitation Nursing on Postoperative Self-care Ability and Nursing Satisfaction of Patients with Proximal Humeral Fracture

Abstract Background Patient-reported outcome measures (PROMs) are gaining increasing importance in the context of quality management. Different PROMs and scoring tools are available to assess shoulder function after proximal humeral fracture (PHFx). In Europe, these include the Constant-Murley Score (CS), Neer Score (NS), Oxford Shoulder Score (OSS), University of California at Los Angeles Score (UCLA) and Disabilities of the Arm, Shoulder and Hands Score (DASH). In addition, the health-related quality of life can be assessed by the PROMs Short Form 36 (SF-36) and EuroQol (EQ-5D). Although all these test instruments assess shoulder function, the components to be answered objectively and subjectively vary and thus the possibility of independent assessment. The aim of the present study is to compare the correlation between the results of the different PROMs and the clinical screening tools in patients with PHFx. Methods 76 patients who were treated with angular stable plate osteosynthesis for a proximal humeral fracture between 01/2001 and 12/2005 were included in this trial. The outcome was measured with PROMs or clinical scoring tools such as CS, NS, OSS, UCLA, DASH, SF-36 and EQ-5D and a correlation coefficient between those evaluation tools was calculated. In addition, a distinction was made between the two force measurement methods (wrist [HG] vs. deltoid muscle [DM]) for CS. Results The correlation of the results of CS and NS (HG: r = 0.85; p < 0.001/DM: r = 0.93; p < 0.001), CS and UCLA (HG: r = 0.83; p < 0.001/DM: r = 0.86; p < 0.001), NS and UCLA (r = 0.91; p < 0.001) as well as DASH and OSS (r = 0.88; p < 0.001) was strongly expressed. A good comparability of the results was demonstrated between CS and OSS (HG: r = 0.63; p < 0.001/DM: r = 0.66; p < 0.001) and between CS and DASH (HG: r = 0.62; p < 0.001/DM: r = 0.61; p < 0.001). The correlation of CS (HG/DM) and UCLA with the EQ-5D index was also good. Assessment of the physical components of SF-36 with CS, NS, OSS, UCLA and DASH showed a moderate to good association, while the mental components of SF-36 showed a low correlation (p > 0.05). Conclusion The assessment of shoulder function after proximal humerus fracture showed a very strong correlation within the clinical questionnaires (CS/NS/UCLA) and the PROMs (OSS/DASH). A strong correlation also exists between the clinical questionnaires and the PROMs. There was only a moderate correlation with the EQ-5D. The moderate to strong correlation between the physical components of SF-36, with almost no correlation between the mental components of SF-36, indicates that the quality of life restriction is based on a physical, but not on a mental impairment.

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Prognosis of proximal humeral fracture.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.39.835 ◽

1990 ◽

Vol 39 (2) ◽

pp. 835-838

Author(s):

Mako Hirano ◽

Kazutoshi Nomura ◽

Meisho So ◽

Toshio Amano

Keyword(s):

Proximal Humeral Fracture ◽

Humeral Fracture

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Five-year outcome after conversion of a hemiarthroplasty when used for the treatment of a proximal humeral fracture to a reverse total shoulder arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.100b6.bjj-2017-1280.r1 ◽

2018 ◽

Vol 100-B (6) ◽

pp. 761-766 ◽

Cited By ~ 25

Author(s):

M. Holschen ◽

M-K. Siemes ◽

K-A. Witt ◽

J. Steinbeck

Keyword(s):

Shoulder Arthroplasty ◽

Proximal Humeral Fracture ◽

Constant Score ◽

Total Shoulder Arthroplasty ◽

Operating Time ◽

Humeral Fracture ◽

Reverse Total Shoulder Arthroplasty ◽

The Mean ◽

Reverse Total Shoulder

Aims The reasons for failure of a hemirthroplasty (HA) when used to treat a proximal humeral fracture include displaced or necrotic tuberosities, insufficient metaphyseal bone-stock, and rotator cuff tears. Reverse total shoulder arthroplasty (rTSA) is often the only remaining form of treatment in these patients. The aim of this study was to evaluate the clinical outcome after conversions from a failed HA to rTSA. Material and Methods A total of 35 patients, in whom a HA, as treatment for a fracture of the proximal humerus, had failed, underwent conversion to a rTSA. A total of 28 were available for follow-up at a mean of 61 months (37 to 91), having been initially reviewed at a mean of 20 months (12 to 36) postoperatively. Having a convertible design, the humeral stem could be preserved in nine patients. The stem was removed in the other 19 patients and a conventional rTSA was implanted. At final follow-up, patients were assessed using the American Shoulder and Elbow Surgeons (ASES) score, the Constant Score, and plain radiographs. Results At final follow-up, the mean ASES was 59 (25 to 97) and the mean adjusted Constant Score was 63% (23% to 109%). Both improved significantly (p < 0.001). The mean forward flexion was 104° (50° to 155°) and mean abduction was 98° (60° to 140°). Nine patients (32%) had a complication; two had an infection and instability, respectively; three had a scapular fracture; and one patient each had delayed wound healing and symptomatic loosening. If implants could be converted to a rTSA without removal of the stem, the operating time was shorter (82 minutes versus 102 minutes; p = 0.018). Conclusion After failure of a HA in the treatment of a proximal humeral fracture, conversion to a rTSA may achieve pain relief and improved shoulder function. The complication rate is considerable. Cite this article: Bone Joint J 2018;100-B:761–6.

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Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2017/3431609 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Wei Zhao ◽

Yuhui Zhang ◽

Dongni Johansson ◽

Xingyu Chen ◽

Fang Zheng ◽

...

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Internal Fixation ◽

Open Reduction ◽

Proximal Humeral Fracture ◽

Plate Osteosynthesis ◽

Meta Analysis ◽

Humeral Fracture ◽

Open Reduction Internal Fixation ◽

Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

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Proximal humeral fracture-dislocation: Outcome analysis in osteosynthesis and arthroplasties

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-021-03183-x ◽

2022 ◽

Author(s):

Samuel Haupt ◽

Sabrina Weber ◽

Herman Frima ◽

René Hutter ◽

Holger Grehn ◽

...

Keyword(s):

Proximal Humeral Fracture ◽

Humeral Fracture ◽

Fracture Dislocation ◽

Outcome Analysis

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Influence of Human-oriented Nursing Mode on Self-Care Ability, Unhealthy Emotion and Quality of Life of Patients with Benign Prostatic Hyperplasia

Tobacco Regulatory Science ◽

10.18001/trs.7.4.1.16 ◽

2021 ◽

Vol 7 (4) ◽

pp. 635-646

Author(s):

Feifei Peng ◽

Guangchi Xu ◽

Caihong Zhu ◽

Lanchun Sun ◽

Bo Dong ◽

...

Keyword(s):

Quality Of Life ◽

Benign Prostatic Hyperplasia ◽

Postoperative Complications ◽

Self Care ◽

Nursing Intervention ◽

Prostatic Hyperplasia ◽

The Self ◽

Nursing Satisfaction ◽

Before And After

To explore the influence of human-oriented nursing mode on the self-care ability, unhealthy emotion and quality of life of patients with benign prostatic hyperplasia (BPH), 147 patients with BPH admitted to our hospital from February 2018 to August 2019 were selected and all patients were separated into two groups on the basis of the nursing intervention mode. 77 cases in the research group (RG) were given the human-oriented nursing mode and 70 cases in the control group (CG) were given the conventional nursing mode. The bladder irrigation time (BIT), indwelling catheter time (ICT), postoperative hospitalization time (PHT) and the incidence rate of postoperative complications were observed in the two groups after nursing intervention. Before and after nursing intervention, the self-care ability of patients was evaluated in the two groups by Exercise of Self-Care Agency Scale (ESCA). In the two groups, the anxiety and depression status were evaluated by the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). The Quality of Life Scale for Benign Prostatic Hyperplasia Patient (BPHQLS) was applied to evaluate the quality of life in both groups before and after nursing intervention. The International Prostate Symptom Score (IPSS) was used to assess the lower urinary tract symptoms (LUTS) of patients in the two groups before and after nursing intervention. The self-made nursing satisfaction questionnaire was used to evaluate the nursing satisfaction in the two groups. The BIT, ICT and PHT in RG after nursing intervention were obviously lower than those in CG, and the incidence of postoperative complications in RG was also obviously lower than that in CG (p < 0.05). The ESCA score of patients in RG after nursing intervention was significantly higher than that in CG (P < 0.05). The SAS and SDS scores of patients in RG after nursing intervention were significantly lower than those in CG (P < 0.05). The BPHQLS score in RG after nursing intervention was obviously higher than that in CG (P < 0.05). The IPSS score of patients in RG after nursing intervention was obviously lower than that in CG (p < 0.05). The nursing satisfaction score in RG after nursing intervention was obviously higher than that in CG (p < 0.05).Condusion: The application effect of the human-oriented nursing mode on patients with BPH is definite, which can improve self-care ability, unhealthy emotion and effectively ameliorate the quality of life.

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Reverse shoulder arthroplasty for proximal humeral fracture in the elderly. Cemented or uncemented stem?

International Orthopaedics ◽

10.1007/s00264-021-05284-y ◽

2022 ◽

Author(s):

Yaiza Lopiz ◽

Carlos García-Fernandez ◽

María Vallejo-Carrasco ◽

Daniel Garriguez-Pérez ◽

Loreto Achaerandio ◽

...

Keyword(s):

Shoulder Arthroplasty ◽

Proximal Humeral Fracture ◽

Reverse Shoulder Arthroplasty ◽

Humeral Fracture ◽

The Elderly

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Single versus Double Skin Preparation for Infection Prevention in Proximal Humeral Fracture Surgery

BioMed Research International ◽

10.1155/2018/8509527 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Davide Blonna ◽

Valeria Allizond ◽

Enrico Bellato ◽

Giuliana Banche ◽

Anna Maria Cuffini ◽

...

Keyword(s):

Proximal Humeral Fracture ◽

Povidone Iodine ◽

Bacterial Load ◽

Positive Culture ◽

Humeral Fracture ◽

Microbiological Analysis ◽

Coagulase Negative Staphylococci ◽

Skin Preparation ◽

Double Skin ◽

Deltopectoral Approach

Preoperative skin preparation plays a major role in preventing postoperative infections. This study aims to compare a single skin preparation (povidone iodine) with a double skin preparation (chlorhexidine gluconate followed by povidone iodine). Forty patients affected by proximal humeral fracture were included in the study. The day of surgery the two skin preparation strategies were performed in the same shoulder, divided into two areas, at the level of the deltopectoral approach. Skin swabs were collected from each area and subjected to microbiological analysis. Both skin preparations significantly reduced the positive culture rate. Coagulase-negative staphylococci (CoNS) dropped from 92.5% to 40% and to 7.5% after the single and double skin preparation (p<0.001), respectively. The positivity rate was reduced from 50% to 17.5% (p=0.002) and from 27.5% to 0% (p= 0.001) for Propionibacterium acnes and Staphylococcus aureus, respectively, with no difference between the two preparations. The double skin preparation had a more significant effect on bacterial load against CoNS compared to the single skin preparation (p<0.001 versus p= 0.015). In conclusion, both the approaches reduced S. aureus and P. acnes skin load, whereas the double skin preparation is more effective than the single one against CoNS. In light of our findings, preoperative strategies able to reduce bacterial load could potentially increase the final efficacy of perioperative traditional skin preparations.

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