Outcomes of proximal humerus fractures in children.

The exposure is a fracture of the proximal humerus sustained when under the age of 18 years. The principal investigator will identify potential participants from the medical records and radiology database of the Women’s and Children’s Hospital (WCH) in South Australia, which is the tertiary referral paediatric centre for orthopaedics for the state of South Australia and surrounding regions of south-western New South Wales and western Victoria. The diagnosis of each potential participant's proximal humerus fracture will be confirmed upon examination of the plain-film radiographs. We will be observing the functional and quality-of-life outcomes of patients who were diagnosed with a proximal humerus fracture at the WCH between 1st January 2010 and 1st June 2020, when under the age of 18 years. Once participants have been identified, the status of the patient will be reviewed on the hospital records to ensure that families of the deceased are not contacted. The potential participant will be mailed a copy of the Letter of Invitation to Participants, the Participant Information Sheet and the Informed Consent Form. If they do not opt out of the study, they will then be contacted via telephone two weeks later and given verbal information about the research project. During this telephone call, the principal investigator will go through a structured questionnaire over the phone. The structured questionnaire will involve questions from the QuickDASH, Shoulder Pain and Disability Index (SPADI) and Paediatric Outcomes Data Collection Instrument (PODCI) questionnaires, which are established outcome measures for assessing functional and quality-of-life outcomes following upper limb pathology. Additionally, participants will complete a questionnaire that we have created that asks demographic questions related to the participant’s current occupation, highest level of education, co-morbidities and other musculoskeletal injuries that they have sustained. The telephone interview is not expected to take more than 45 minutes to complete. At the conclusion of the telephone interview, a time and date will be arranged for the participant to have a 15-minute clinic appointment either in-person or via Zoom, to allow for the brief shoulder examination. The clinic appointment will occur 1-2 weeks following the telephone interview for each participant. Both the telephone interview and clinic appointment will be conducted by the principal investigator, who is an orthopaedic registrar with a particular interest in paediatric orthopaedics. Radiological outcomes following fracture and complications of treatment will also be assessed for each participant up to a maximum of two years post-fracture, by retrospectively accessing imaging results in the hospital's radiology database and the hospital medical records. This will not require any additional involvement by the participant.