Surgery for broken arm does not improve outcome for most patients
The results of a randomised trial have found that many broken arms could be allowed to heal on their own without routine treatment with surgery.
Researchers studied 231 patients admitted to British hospitals for displaced fractures of the proximal humerus involving the surgical neck. The researchers randomly assigned 114 to surgery and 117 to simply immobilising the arm in a sling. The study, published in the Journal of the American Medical Association, followed patients for the next two years, examining them at regular intervals.
Overall, the surgical and non-surgical groups had similar outcomes, with no difference on measures of pain and comfort. But heart, respiratory and other complications were more common in the surgery group.
Lead author, Amar Rangan, a clinical professor at James Cook University Hospital in Middlesbrough, said that the types of break requiring surgery were not included in the study.
“Patients are already anxious when they arrive with a broken bone,” he said. “On the back of this study, we can reassure them that surgery is not essential.”
Rangan, A., Handoll, H., Brealey, S., et al. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: The PROFHER randomized clinical trial. JAMA. 2015;313(10):1037-1047. doi:10.1001/jama.2015.1629