OBJECTIVES : Successful operative management of traumatic humerus fractures can consist of open reduction with internal fixation (ORIF) which provides pain relief, anatomic reduction, and overall bone stability. Little to no information is known about related healthcare resource utilization and complications associated with ORIF in the real-world. The purpose of this study was to evaluate the hospital length of stay (LOS) for ORIF, 1-year complications rates and healthcare resource utilization associated with ORIF for humerus fractures.

METHODS : This retrospective observational cohort analysis used the IBM Marketscan Commercial and Medicare databases between 2010 and 2017. The study included patients ≥18 years, diagnosed with humerus fractures, and treated with ORIF (index) in an inpatient setting. Patients were included if they had continuous enrollment between 6-month pre-index and 1-year post-discharge from index hospitalization. Patients with polytrauma 6 months prior to index were excluded. Mean LOS at index, 1-year complication rates including infections and nonunion, healthcare resource utilization in terms of reoperations, all-cause readmission and emergency visits and all-cause costs within 1 year after discharge from index hospitalization were estimated.

RESULTS : A total of 6,413 patients with ORIF for humerus fractures were included. Patients were predominantly females (67.0%) with mean (SD) age of 59.5 (19.8) years. The mean (SD) LOS and costs at time of index surgery were 3.9 (4.0) days and $32,003 ($46,270) respectively. During a 1-year follow-up period, 6.3% of the patients developed infection, 11.0% had non-union, and 13.7% had reoperations. All cause-readmission rates reached 22.1% with 30.3% of emergency visits. The mean (SD) all-cause post-discharge costs within 1 year was $ 29,609 ($48,217).

CONCLUSIONS : Patients with humerus fractures had a mean LOS of about 4 days for ORIF hospitalization and experienced high complications rates. One-year post-discharge healthcare resource utilization and all-cause costs associated were also high for these patients.