ArticleEFORT open reviews2018
Ischaemia, healing and outcomes in proximal humeral fractures.
Article in EFORT open reviews, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Locking plates versus intramedullary nails for the treatment of two- and three-part proximal humerus fractures in patients older than 60 years: a meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Vascular impulse technology versus elevation for reducing the swelling of upper and lower extremity joint fractures.Scientific reports · 2023Trial
- Functional outcomes and complications after locked plating of fracture-dislocations of the proximal humerus and the significance of the intertuberosity periosteal bridge.Shoulder & elbow · 2026Article
- Ligation of the anterior humeral circumflex artery ablates blood flow to the lesser tuberosity osteotomy in a cadaveric model.JSES reviews, reports, and techniques · 2026Article
- Risk factors for cephalic necrosis after plate and screw osteosynthesis of 3- and 4-part proximal humerus fractures: prospective cohort study of 121 patients.Musculoskeletal surgery · 2026Article
- Does the Hertel criteria correlate with postoperative avascular necrosis and failure in proximal humerus fractures? A retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Proximal Humerus Fractures - A Contemporary Narrative Review of Management Strategies.Orthopedic reviews · 2026Article
- Progress in the treatment of complex osteoporotic proximal humeral fractures in elderly patients.Frontiers in surgery · 2026Review
- Technical note: reduction of a posteriorly dislocated humeral head via the anterior deltopectoral approach in a posterior fracture dislocation of the proximal humerus.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Intraoperative Doppler flowmetry evaluation of humeral head perfusion after proximal humerus fracture.JSES international · 2024Article
- Intramedullary nailing of proximal humerus fractures does not achieve superior functional results to non-operative treatment in the long term.Archives of orthopaedic and trauma surgery · 2024Article
- Prediction of the Proximal Humerus Morphology Based on a Statistical Shape Model with Two Parameters: Comparison to Contralateral Registration Method.Bioengineering (Basel, Switzerland) · 2023Article
- Fracture line and comminution zone characteristics, and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humeral fractures: complex proximal humerus fracture map.Archives of orthopaedic and trauma surgery · 2023Article
- Infected haematoma in non-immuno-compromised patients following conservatively managed glenohumeral fractures - case reports.Shoulder & elbow · 2023Article
- Statistical Morphology and Fragment Mapping of Complex Proximal Humeral Fractures.Medicina (Kaunas, Lithuania) · 2023Article
- Comparison of surgical efficacy of locking plates and interlocking intramedullary nails in the treatment of proximal humerus fractures.Journal of orthopaedic surgery and research · 2022Article
- Computed Tomography Does Not Improve Intra- and Interobserver Agreement of Hertel Radiographic Prognostic Criteria.Medicina (Kaunas, Lithuania) · 2022Article
- Specific Radiologic Risk Factors for Implant Failure and Osteonecrosis of the Humeral Head after Interlocking Nailing with the Targon PHJournal of clinical medicine · 2022Article
- Protective and Risk Factors for Humerus Head Necrosis After Proximal Humerus Fracture Treated with Internal Locking Plate.Indian journal of orthopaedics · 2022Article
- ESTES recommendations on proximal humerus fractures in the elderly.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Interfragmental ischaemia is a prerequisite for the initiation of the inflammatory and immunological response to fracturing of bone.Intrafragmental ischaemia is inevitable: the extent of the initial ischaemic insult does not, however, directly relate to the outcome for healing of the fracture zones and avascular necrosis of the humeral head. The survival of distal regions of fragments with critical perfusion may be the result of a type of inosculation (blood vessel contact), which establishes reperfusion before either revascularization or neo-angiogenesis has occurred.Periosteum has a poorly defined role in fracture healing in the proximal humerus. The metaphyseal periosteal perfusion may have a profound effect, as yet undefined, on the healing of most metaphyseal fractures of the proximal humerus, and may be disturbed further by inadvertent surgical manipulation.The metaphysis can be considered as a 'torus' or ring of bone, its surface covered by periosteum antero- and posterolaterally, through which the tuberosity segments gain perfusion and capsular reflections antero- and posteromedially, through which the humeral head (articular) fragment gains perfusion.The torus is broken in relatively simple primary patterns: a fracture line at the upper surface of the torus is an anatomical 'neck' fracture; a fracture line at the lower surface of the torus is the surgical 'neck' fracture. Secondary fragmentation (through compression and/or distraction) of the torus itself creates complexity for analysis (classification), alters the capacity and outcome for healing (by variable interruption of the fragmental blood supply) and influences interfragmental stability. Cite this article:
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