# Neuroticism is related to functional outcomes after surgically treated proximal humerus fractures

## TL;DR

This study shows that higher neuroticism is linked to worse recovery after surgery for shoulder fractures.

## Contribution

It identifies neuroticism as a novel psychological factor affecting functional outcomes after proximal humerus fracture surgery.

## Key findings

- Higher neuroticism correlates with lower Constant Shoulder Scores (CSS) for the fracture side.
- Neuroticism is strongly linked to worse Oxford Shoulder Scores and higher disability scores.
- No correlation was found between neuroticism and CSS difference between sides.

## Abstract

It is known that physical factors play an important role in the outcome after a proximal humerus fracture (PHF). However, an increasing body of evidence shows that psychological factors are of importance as well. As such, it follows that the level of neuroticism in a patient might be especially important. This study aims to examine the correlation between neuroticism levels and functional outcomes following surgically treated PHFs.

This is a retrospective cohort analysis. Patients with PHFs who were surgically treated from 2013 to 2023 and had a minimum 1-year follow-up were eligible. During follow-up, shoulder range of motion and functional scores (Constant Shoulder Score [CSS], Oxford Shoulder Score, and quick Disability of the Arm, Shoulder and Hand) were measured. To ascertain the level of neuroticism, the short-revised version of the Eysenck Personality Questionnaire was administered.

In total, 65 patients were included in the study. Eighty-nine percent of included subjects were women (n = 58) and the median age was 72.3 ± 7.4 years. Seventy-four percent (n = 48) was treated with a reverse total shoulder arthroplasty and 60% (n = 39) was operated on their dominant side. The level of neuroticism is correlated with the CSS for fracture side (r = −0.28; P = .023), correlated with the Oxford Shoulder Score (r = −0.46; P < .001) and to the quick Disability of the Arm, Shoulder and Hand (r = 0.30; P = .017). The CSS difference score between the fracture side and the nonaffected side was not correlated with the level of neuroticism (r = 0.20; P = .12).

A higher level of neuroticism is related to worse functional outcomes after a surgically treated PHF.