Operative treatment
Operative treatment has been studied in 7 papers since 2017: 2 trials and 5 observational studies in people. The newest paper, Oct 11, 2025: “Mortality from tibial shaft fractures in the elderly (MTFE)-a multicentre study of management outcomes”.
7 papers study it12 findingsUpdated
“The Barthel index (= 0.325), VAS (p = 0.711), quality of life (p = 0.824), and Tinetti-Gait Test (p = 0.913) showed no significant differences between the two groups after 12 months.”
2 of its findings point the other way.
- 3 independent labs in 2 countries
- 2 findings against
- Funder: Universitaetsklinikum Hamburg-Eppendorf
- Human trial2
- Humans5
Studies in people
2 studies gave operative treatment to people and measured what changed.
no change: Has no effect on mortality
no change: Has no effect on physical function
Randomized trial39 people92.3% female/7.7% maleover 60 years12.9 months
Elderly patients with a type B2.1 or FFP II posterior pelvic ring fracture
Scientific reports, Sep 26, 2023
down: Decreases mortality90.7% vs 74.7% (p=.023)
up: Increases painsignificantly higher mean
up: Raises the risk of complications31.0% vs 14.9% (p=.04)
Treated cohort151 peopleBoth65-96one year
Older adults; fragility fractures of the pelvis
Injury, Oct 1, 2021
What did studies of Operative treatment find?
4Studies of Operative treatment measured 4 outcomes; the most studied are physical function (2 studies), mortality (2) and pain (2).
Physical function
no changein humans2
2 studies
Physical function
no changein humans2
Operative treatment has no effect on physical function in humans.
“After 12 months, there were no significant differences in the Barthel index (p = 0.3), VAS pain (p = 0.7), quality of life (p = 0.8), and Tinetti–Gait Test (p = 0.9).”
Human trialcompared to conservative treatment12.9 monthsn = 39
Scientific reports
Operative treatment has no effect on physical function in humans (p = 0.325 for Barthel index, p = 0.711 for VAS, p = 0.824 for quality of life, p = 0.913 for Tinetti-Gait Test).
“The Barthel index (= 0.325), VAS (p = 0.711), quality of life (p = 0.824), and Tinetti-Gait Test (p = 0.913) showed no significant differences between the two groups after 12 months.”
Human trialfragility fractures of the pelvic ring (FFP II)12 monthsn = 39
Scientific reports
Operative treatment has no effect on physical function in humans.
“No significant difference was found between the two treatment groups in HRQoL (p = 0.43), function (p = 0.78) and pain (p = 0.19).”
Humansdisplaced 3- or 4-part proximal humeral fracture; compared with nonoperative treatment1–10 years
European journal of trauma and emergency surgery : official publication of the European Trauma Society
Mortality
no changein humans1downin humans1
2 studies
Mortality
no changein humans1downin humans1
Operative treatment has no effect on mortality in humans.
“Nevertheless, no significant difference between the ST and CCT group survival rates was observed (Log Rank Chi2 = 1.842, p = 0.2; Fig. ).”
Human trialcompared to conservative treatment12.9 monthsn = 39
Scientific reports
Operative treatment has no effect on mortality in humans (p = 0.175).
“The one-year mortality rate showed no significant difference (p = 0.175).”
Human trialfragility fractures of the pelvic ring (FFP II)12 monthsn = 39
Scientific reports
Operative treatment decreases mortality in humans (90.7% vs 74.7% (p=.023)).
“The survival of the operative treatment group was 90.7% (49/54) and significantly higher than the survival of the conservative treatment group (74.7%; 56/75; p=.023).”
Humansfragility fractures of the pelvisone year
Injury
Pain
upin humans1no changein humans1
2 studies
Pain
upin humans1no changein humans1
Operative treatment increases pain in humans (significantly higher mean).
“The one-year follow up showed a high dispersion of the pain level in the operatively treated patients and a significantly higher mean in comparison to conservatively treated patients.”
Humansfragility fractures of the pelvisone year
Injury
Operative treatment has no effect on pain in humans.
“No significant difference was found between the two treatment groups in HRQoL (p = 0.43), function (p = 0.78) and pain (p = 0.19).”
Humansdisplaced 3- or 4-part proximal humeral fracture; compared with nonoperative treatment1–10 years
European journal of trauma and emergency surgery : official publication of the European Trauma Society
Health-related quality of life
no changein humans1
1 study
Health-related quality of life
no changein humans1
Operative treatment has no effect on health-related quality of life in humans.
“No significant difference was found between the two treatment groups in HRQoL (p = 0.43), function (p = 0.78) and pain (p = 0.19).”
Humansdisplaced 3- or 4-part proximal humeral fracture; compared with nonoperative treatment1–10 years
European journal of trauma and emergency surgery : official publication of the European Trauma Society
What is Operative treatment linked with?
3Studies link Operative treatment with 3 measures, most often complications (1 study), reinterventions (1) and social participation (1).
Complications
upin humans1
1 study
Complications
upin humans1
Operative treatment raises the risk of complications in humans (31.0% vs 14.9% (p=.04)).
“Overall in 31.0% (18/58) of the operative participants and in 14.9% (14/93) of the non-operatively treated participants complications occurred (p=.04).”
Humansfragility fractures of the pelvisone yearn = 151
Injury
Reinterventions
upin humans1
1 study
Reinterventions
upin humans1
Operative treatment is associated with reinterventions in humans (8 versus 2 reinterventions; p = 0.08).
“More complications and reinterventions occurred in the operative group than the nonoperative group”
Humansdisplaced 3- or 4-part proximal humeral fracture; compared with nonoperative treatment1–10 years
European journal of trauma and emergency surgery : official publication of the European Trauma Society
Social participation
upin humans1
1 study
Social participation
upin humans1
Operative treatment is associated with social participation in humans (Nonsignificant trend; p = 0.09).
“A trend toward better social participation in the operative group (p = 0.09) was found.”
Humansdisplaced 3- or 4-part proximal humeral fracture; compared with nonoperative treatment1–10 years
European journal of trauma and emergency surgery : official publication of the European Trauma Society