Disparities in 1-Year Follow-up Rates After Proximal Humerus Fractures Treated With Open Reduction and Internal Fixation

Background: Proximal humerus fractures (PHFs) impose a serious burden on patients and are commonly treated with open reduction and internal fixation (ORIF). Several factors influence functional outcomes in treating PHFs. This study aims to evaluate how social determinants of health affect postoperative follow-up rates of patients treated with ORIF for PHF. Methods: A single-center retrospective review included 92 patients treated with ORIF for PHF. Loss to follow-up was defined as failing to return after the last advised follow-up. Patient zip codes were used to determine median household income as determined by the US Department of Housing and Urban Development (HUD) and the Federal Reserve and social disadvantage using the Social Deprivation Index (SDI). Results: A significant difference was observed in 12-month loss to follow-up rates between HUD and SDI subgroups. No difference was found in 6-month loss to follow-up rates or the reasons that patients were lost to follow-up among HUD, Federal Reserve, and SDI subgroups. Conclusion: Patients from areas of greater socioeconomic deprivation exhibited the highest 12-month loss to follow-up rates, emphasizing the importance of targeted interventions, such as in-house social workers and improved visit reminders, to address postoperative attrition and enhance patient care.