Evidence map›Paper›PMID 28120283›Full record

ArticleMusculoskeletal surgery2017

Surgical management of complex proximal humeral fractures: pinning, locked plate and arthroplasty : Clinical results and functional outcome on retrospective series of patients.

I Repetto, M Alessio-Mazzola, P Cerruti, F Sanguineti, M Formica, L Felli

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Musculoskeletal surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Clinical outcomes of cemented vs. uncemented reverse total shoulder arthroplasty for proximal humerus fractures: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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  5. Article
  6. Prosthetic treatment of proximal humerus fractures in the elderly.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Review
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  11. Comparison of effective factors in loss of reduction after locking plate-screw treatment in humerus proximal fractures.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

I RepettoDepartment of Surgical Sciences (DISC), Orthopaedic Clinic, Pad. 40, IRCCS San Martino IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
M Alessio-MazzolaDepartment of Surgical Sciences (DISC), Orthopaedic Clinic, Pad. 40, IRCCS San Martino IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy. mattia.alessio@hotmail.com.
P CerrutiDepartment of Surgical Sciences (DISC), Orthopaedic Clinic, Pad. 40, IRCCS San Martino IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
F SanguinetiDepartment of Surgical Sciences (DISC), Orthopaedic Clinic, Pad. 40, IRCCS San Martino IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
M FormicaDepartment of Surgical Sciences (DISC), Orthopaedic Clinic, Pad. 40, IRCCS San Martino IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
L FelliDepartment of Surgical Sciences (DISC), Orthopaedic Clinic, Pad. 40, IRCCS San Martino IST, Largo Rosanna Benzi 10, 16132, Genoa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of the study was to compare the clinical results and related complications of four different surgical treatments of complex proximal humeral fractures according to their classification and features of patients.

methodsBetween 2007 and 2011, 92 consecutive patients with diagnosis of three-four-part displaced fractures, fractures with head dislocation and head-splitting fractures were evaluated postoperatively with Constant-Murley score, disability of arm, shoulder and hand score and simple shoulder test.

resultsAll the treatment modalities showed from optimal to good mean functional results. The statistical analysis comparing each treatment group showed better outcomes scores (p < 0.05) for: locked plating versus HA, locked plating versus RSA and RSA versus HA. No differences between postoperative range of motion, complication rate and overall revision rate of the treatment groups were found at the end of follow-up (p > 0.05). Overall complication rate of surgical treatment of complex PHF was 31.5% (29 patients) with overall revision rate of 14.1%. Among patients with complications 77.8% of HA (7 of 9) required revision surgery (p < 0.05).

conclusionsThe treatment of complex PHF is nowadays a challenge even for skilled shoulder surgeons. The several viable operative options give good results whenever used for the correct indication. The range of reported complications from 18.2 to 37.5% remains concerning, but most of them did not affect clinical outcome in this series. Accurate preoperative characterization of the fracture pattern is necessary, and high surgical skills of the different operative techniques, including arthroplasty, are recommended to meet the increased functional expectations of patients. LEVEL OF EVIDENCE: Therapeutic series, Level IV.

Indexed as

Arthroplasty, Replacement, ShoulderBone NailsBone PlatesFracture Fixation, InternalAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesShoulder FracturesTreatment OutcomePHILOS platePinning techniqueProximal humeral fractureReverse shoulder arthroplastyShoulder hemiarthroplastySurgical treatment

Identifiers

PMID28120283

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.