[Shoulder prosthesis in complex proximal humeral fractures]
Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A, Ciapponi A.
Record ID 32018001552
Spanish
Original Title:
Prótesis de hombro en fracturas complejas del extremo proximal del húmero
Authors' recommendations:
High-quality evidence states that, in patients with complex proximal humeral fractures, surgical treatment options do not have significant advantages when compared with conventional treatment in terms of better functionality and fewer complications and/or reoperations.
High-quality evidence shows that treating these fractures with reverse prosthesis is not associated with better results in terms of function improvement and pain in the fractured extremity when compared with conventional treatment.
Prosthetic shoulder replacement in complex proximal humeral fracture treatment is not listed in the Mandatory Medical Plan coverage and cannot be recovered through Argentina’s Unique Reimbursement System. Private funders from the United Kingdom, Uruguay and Chile do not cover this practice for this indication either and the NICE’s clinical practice guideline for fracture management recommends conventional treatment for this indication. Funders from France, Canada, Australia and the United States cover these practices, however, in some cases, coverage is restricted to those fractures that cannot undergo surgical reconstruction using other methods. Two United States clinical practice guidelines mention prosthetic shoulder as an alternative for complex proximal humeral fracture treatment.
No economic evaluations conducted in Argentina or Latin America are available; however, its high cost when compared with conventional treatment, not accounting for a clear added benefit, would lead to assume that it would not be a cost-effective option in Argentina. An economic evaluation conducted in the United Kingdom found that, in subjects with displaced proximal humeral fracture, conventional treatment was dominant (less expensive and more effective) when compared with surgical treatment.
Details
Project Status:
Completed
Year Published:
2019
URL for published report:
https://www.iecs.org.ar/home-ets/
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Argentina
MeSH Terms
- Arthroplasty, Replacement, Shoulder
- Shoulder Joint
- Shoulder Prosthesis
- Humeral Fractures
Contact
Organisation Name:
Institute for Clinical Effectiveness and Health Policy
Contact Address:
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name:
info@iecs.org.ar
Contact Email:
info@iecs.org.ar
Copyright:
Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.