Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2022; 13(3): 297-306
Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.297
Plate vs reverse shoulder arthroplasty for proximal humeral fractures: The psychological health influence the choice of device?
Giuseppe Maccagnano, Giuseppe Solarino, Vito Pesce, Giovanni Vicenti, Michele Coviello, Vittorio Saverio Nappi, Orazio Valerio Giannico, Angela Notarnicola, Biagio Moretti
Giuseppe Maccagnano, Vito Pesce, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Foggia, Orthopaedics Unit, General Hospital, Foggia 71122, Italy
Giuseppe Solarino, Giovanni Vicenti, Michele Coviello, Angela Notarnicola, Biagio Moretti, Department of Basic Medical Science, Neuroscience and Sensory Organs, Faculty of Medicine and Surgery, University of Bari, Orthopaedics Unit, General Hospital, Bari 70124, Italy
Vittorio Saverio Nappi, Orthopaedics Unit, Di Venere General Hospital, Bari 70124, Italy
Orazio Valerio Giannico, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari 70124, Italy
Author contributions: Maccagnano G drafted the manuscript, and assisted with data analysis; Solarino G participated in design and oversight of the study; Pesce V drafted the manuscript, and assisted with data analysis; Vicenti G participated in study design and performed statistical analysis; Nappi VS participated in design of the study, and was involved with data collection; Coviello M was involved with data collection, and assisted with data analysis; Giannico OV participated in study design and performed statistical analysis; Notarnicola A participated in design of the study; Moretti B participated in design and oversight of the study.
Institutional review board statement: The authors conducted a prospective observational study with a sequential recruitment of subjects affected by proximal humeral fractures, which was approved by the local Ethics Committee (No. 6809).
Clinical trial registration statement: The study was also registered on ClinicalTrials.gov, Protocol Registration and Result System (PRS) (NCT04821180).
Informed consent statement: All patients were properly informed of the nature of the study and they signed an informed consent document according to the Declaration of Helsinki.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest regarding the publication of this paper.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Solarino, MD, PhD, Associate Professor, Department of Basic Medical Science, Neuroscience and Sensory Organs, Faculty of Medicine and Surgery, University of Bari, Orthopaedics Unit, General Hospital, Piazza Giulio Cesare, 11, Bari 70124, Italy. giuseppe.solarino@uniba.it
Received: April 17, 2021
Peer-review started: April 17, 2021
First decision: June 23, 2021
Revised: July 6, 2021
Accepted: February 19, 2022
Article in press: February 19, 2022
Published online: March 18, 2022
ARTICLE HIGHLIGHTS
Research background

Patient affected by fractures is evaluated only from a surgical point of view. Psychological aspect is very often underestimated.

Research motivation

More studies are needed in literature, to evaluate before surgical choice not only anatomical parameters but also patient psychological profile.

Research objectives

The aim of our study was to compare open reduction and internal fixation with joint replacement in terms of clinical and psychological outcomes of three- and four- part proximal humeral fractures in patients older than 65 years evaluating whether post-operative psychological symptoms may influence the clinical results after surgery.

Research methods

An observational prospective single-center study with 12 mo follow-up was performed with a sequential recruitment of subjects affected by proximal humeral fractures treated with open reduction and internal fixation and joint replacement. A conservative treatment group, as control, was introduced.

Research results

Patients underwent primary reverse shoulder arthroplasty showed in each postoperative follow-ups a generalized anxiety disorder and a greater irritability then patients underwent osteosynthesis.

Research conclusions

Patient psychological profile should be evaluated by the surgeon before surgery for the choice of surgical devices.

Research perspectives

Future investigations are needed to confirm the role of the psychological profile in the field of orthopedic surgical treatment. In addition, long- term analysis needs to clarify if differences in outcomes are really related to the patient’s mental state.