Direct medical cost of late rehabilitation in workers with conservatively managed proximal humerus fracture.

B I Navarrete-Peñaloza, H Hernández-Amaro

Eighty percent of the Proximal humerus fractures are not displaced or minimally displaced and stable. The international treatment recommendation is conservative. Immobilization of the limb carries risk of stiffness, pain and decreased function. Currently being used rehabilitation programs with early mobilization of the injured shoulder within the first week post-fracture, with evidence of early functional and labor recovery and with no risk for displacement of fragments. However, in our country, these patients start rehabilitation late, which leads to a delay in the recovery of functionality and delay in returning to work, translating into increased costs. At the moment there is no national benchmark for the cost of this late-onset rehabilitation. From a non-probabilistic sample for convenience, were analyzed records of 52 patients, treated in the period from January to December 2019. Inclusion criteria were workers diagnosed with a proximal humeral fracture, conservative management; exclusion criteria were peripheral nerve injury, aggregate fracture or surgically treated. The mean direct medical cost was $19,090.69 Mexican pesos, directly proportional to the days of stay in the unit and disability. Late rehabilitation leads to more days of disability than recommended by the based guidelinesin the workload, therefore, higher cost.