SynthesisJournal of orthopaedic surgery and research2020
Conservative treatment of 3-part and 4-part proximal humeral fractures: a systematic review.
Synthesis in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled 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.
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.
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Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Reverse arthroplasty compared to hemiarthroplasty and open reduction and internal fixation for displaced proximal humerus fracture in patients above 60: a Bayesian network meta-analysis.Archives of orthopaedic and trauma surgery · 2025Pooled it
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- Comparison between arthroplasty and non-operative treatment for proximal humeral fractures: a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- The fragility and reverse fragility indices of proximal humerus fracture randomized controlled trials: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- A cross-sectional survey comparing management of proximal humerus fractures across a multinational upper limb specialist surgeon panel.JSES reviews, reports, and techniques · 2026Article
- Reverse shoulder arthroplasty for acute Neer type III and IV proximal humeral head fractures with different humeral stem inclination versus nonsurgical treatment: a prospective, single-blinded, randomized controlled trial.JSES international · 2026Article
- Fewer major complications but more pain in reverse shoulder arthroplasty compare with open reduction internal fixation in closed proximal humerus fracture: a National database study.Journal of orthopaedic surgery and research · 2026Article
- Radiological Outcomes, Complications, and the Influence of Risk Factors in PHILOS Repair of Three- and Four-Part Proximal Humerus Fractures with and Without Femoral Head Allograft: Insights from a Cohort of 116 Patients.Journal of clinical medicine · 2026Article
- Table Slide Shoulder Flexion test for early assessment following proximal humeral fracture: development and reliability.BMC musculoskeletal disorders · 2025Article
- Assessment of fracture stability following modified minimally invasive reduction osteosynthesis system (MIROS) fixation for Neer 2 and 3-Part proximal humeral fractures.BMC musculoskeletal disorders · 2025Article
- The feasibility, acceptability, safety, and effects of early weight bearing in humeral fractures - a scoping review.Disability and rehabilitation · 2025Article
- Sentinel fracture: the necessity of improved post-fracture care.Wiener medizinische Wochenschrift (1946) · 2025Review
- Return to work after proximal humeral fractures: a single center study comparing conservative versus operative treatment.Orthopedic reviews · 2025Article
- Does primary treatment of proximal humerus fractures show favourable functional outcomes over secondary treatment with reverse shoulder arthroplasty?Shoulder & elbow · 2024Article
- Predictive Factors for Poor Prognosis in Non-Surgical Treatment of Proximal Humerus Fractures in Elderly Patients.Cureus · 2024Article
- Straight intramedullary MultiLoc nails for displaced proximal humeral fractures: health status, radiographic results, clinical outcome, and complications.BMC musculoskeletal disorders · 2024Article
- 6-Pin Technique Joshi External Stabilization System Fixation for Proximal Humerus Fractures - A Case Series.Journal of orthopaedic case reports · 2023Article
- PlateWorld journal of orthopedics · 2022Article
- Pegs not superior to screws for fixation of fractures of the proximal humerus.Journal of orthopaedic surgery and research · 2022Article
- Projections of Primary and Revision Shoulder Arthroplasty until 2040: Facing a Massive Rise in Fracture-Related Procedures.Journal of clinical medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough there are numerous publications about surgical treatment of proximal humeral fractures (PHFs), few assess conservative treatment, which is the most common approach. The aim of this systematic literature review was to assess criteria for indications, treatment protocols, and outcomes obtained with the conservative treatment of 3-part and 4-part PHF.
methodsWe searched the PubMed and Cochrane databases for clinical studies published between 2000 and 2019 on conservative treatment for 3-part and 4-part PHF that included patients older than 18 years, a minimum follow-up of 1 year, fracture classification, and description of outcomes with assessment scales.
resultsThe search yielded 26,660 records. We reviewed 44 of them in full, and finally 6 studies were included. We obtained a population of 133 patients (79% women), with a mean age of 74.3 years (range 25 to 98) and mean follow-up of 32 months (range 12 to 68.8). According to the Neer classification system, there were 41% (55) three-part fractures and 59% (78) four-part fractures; 5.81% of the patients were lost to follow-up. The mean Constant score was 64.5 for three-part fractures and 54.9 patients with four-part fractures. Consolidation was achieved in 95% of the three-part fractures and 91% of the four-part fractures. Loss of mobility varied according to the type of fracture. Regarding complications, the most frequent was malunion (21%), followed by avascular necrosis (9%).
conclusionsOur data show that most three-part PHFs treated conservatively achieve fracture consolidation even noting a negligible rate of malunion got fair-good functional results with few complications, while the orthopedic four-part PHF treatment presents high rate of consolidation with less rate of malunion than the three-part PHF but achieve poor functional results with few complications. LEVEL OF EVIDENCE: Level IV, Systematic Review.
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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.