The impact of full-thickness rotator cuff tear on shoulder function and quality of life in patients who sustain a proximal humerus fracture: a prospective cohort study

Helle K. Østergaard, Antti P. Launonen, Bakir O. Sumrein, Marianne T. Vestermark, Juha Paloneva, Minna K. Laitinen, Ville M. Mattila, Inger Mechlenburg

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    Abstract

    Background: Only few studies have investigated the impact of rotator cuff integrity on patients with proximal humerus fracture (PHF). We aimed to determine if the presence of a rotator cuff tear impairs shoulder function and health-related quality of life (HRQoL) after nonsurgically treated PHF. Methods: Sixty-seven patients with PHF were recruited prospectively in a cohort. Presence of a full-thickness rotator cuff tear was determined by ultrasound examination. After 6 and 12 months, Constant-Murley Score; Disability of the Arm, Shoulder and Hand; the Visual Analog Scale; EuroQol-5 Domain; and the 15D scores were compared between the patients with a rotator cuff tear and patients with an intact rotator cuff. Results: The prevalence of a full-thickness rotator cuff tear was 34%. After 12 months, the mean Constant-Murley Score was 65.7 (standard deviation 16.3) in the intact rotator cuff group vs. 53.9 (16.0) in the rotator cuff tear group (mean diff. 11.8, 95% confidence interval 2.5; 21.2) and was found to be a clinically relevant difference. A significantly lower HRQoL was found on the EuroQol-5 Domain score after 12 months in the rotator cuff tear group with a median score of 1 (interquartile range 0.23) in the intact rotator cuff group vs. 0.75 (interquartile range 0.34) in the rotator cuff tear group (P =.03). In the remaining outcome measures, no statistically significant between-group differences were detected. Conclusion: Rotator cuff tear in older adults with nonsurgically treated PHF may be considered a prognostic factor for poorer shoulder function and HRQoL. This knowledge can support the planning of treatment.

    Original languageEnglish
    JournalJournal of shoulder and elbow surgery : JSES International
    Volume6
    Issue number2
    Early online date16 Dec 2021
    DOIs
    Publication statusPublished - 2022
    Publication typeA1 Journal article-refereed

    Keywords

    • Health-related quality of life
    • Level I
    • Older adults
    • Pain
    • Prognosis Study
    • Prospective Cohort Comparison
    • Proximal humerus fracture
    • Rotator cuff tear
    • Shoulder function

    Publication forum classification

    • Publication forum level 1

    ASJC Scopus subject areas

    • Orthopedics and Sports Medicine
    • Surgery

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