Senior doctor Alexander Nilsskog Fraser at the orthopedic department and the REMEDY center at Diakonhjemmet hospital received a prestigious award at the European EFORT [1] congress in May 2024. The five-year results from the DelPhi study will be able to influence future guidelines.
Alexander Nilsskog Fraser received first prize for five-year follow-up of the Delphi study: Elderly patients with the most serious shoulder fractures have significantly better results after surgery with reverse shoulder prosthesis compared to surgery with plates and screws. Left, EFORT President David Limb.
Multicenter study
The DelPhi study is a multicentre randomized controlled trial (RCT) comparing reverse shoulder replacement with plate fixation as operative treatment for elderly patients with displaced fractures of the proximal humerus. Project manager Tore Fjalestad started the DelPhi study in 2013, and Fraser defended his PhD on, among other things, the 2-year results of the study in 2023. In addition to Ullevål Hospital, six other hospitals participated, including Diakonhjemmet Hospital.
Study setup and implementation
The comprehensive study is a collaboration between orthopedists, radiologists and physiotherapists at each of the hospitals, who have participated with inclusion, surgery, follow-up and reporting of how patients score on various measurement points.
- Thanks to funding from the Research Council, through REMEDY, it has been possible for me to contribute to processing data and to write the DelPhi 5-year study as part of my postdoctoral period, Alexander Nilsskog Fraser says.
Publication and international interest
The two-year results from the study were published in the renowned American journal Journal of Bone & Joint Surgery (JBJS Am), and recently the five-year article was accepted for publication in the same journal.
- There has been considerable interest in the study both nationally and internationally, says Fraser.
In addition to the Norwegian Orthopedic Autumn Meeting and Nordic forums, the study has been presented at several major orthopedic congresses in Europe and the USA.
Award-winning research
EFORT is a European organization that links national orthopedic associations, focuses on education and research and is known, among other things, for the summary articles EFORT Open Reviews. Every year, 40 abstracts in the categories "Trauma" and "Orthopedics" are nominated for the EFORT Best Paper Prize, and this year the DelPhi 5-year study won the prestigious first prize in the Trauma category.
The importance of 5-year results
Fraser explains that five years of follow-up is crucial for how to assess the results, as two years of follow-up is considered short in the context of prosthetics.
- The data from the DelPhi study are unique as five-year RCT [2] data on reverse prosthesis as a treatment for shoulder fractures have not previously been published. Elderly patients with the most serious fractures have significantly better clinical results with reverse shoulder prosthesis compared to plate fixation, he says.
Fraser extends a big thank you to everyone who participated and contributed to the study, including orthopedists, radiologists and physiotherapists at each participating hospital.
- The great effort of many has been decisive in improving the treatment of shoulder fractures in the elderly, emphasizes Alexander Nilsskog Fraser.
Read more:
Awards Winners 2024 - EFORT Congress Hamburg 2024 - EFORT
Fracture in the upper part of the humerus - Oslo University Hospital HF
Disputed on complicated upper arm fractures - Diakonhjemmet hospital
Public Defence: Alexander Nilsskog Fraser - Institute of Clinical Medicine
[1] The European Federation of National Associations of Orthopaedics and Traumatology
[2] Randomized controlled trial
