Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Conservative treatment of displaced isolated proximal humerus greater tuberosity fractures: preliminary results of a prospective, CT-based registry study.
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03060876 (Prospective Register Study of Patients After Proximal Humerus and Humerus Shaft Fracture for Data Collection of Healing Process, Quality of Life and Shoulder Function According to the Treatment Method - Hanover Humerus Register), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Prospective Register Study of Patients After Proximal Humerus and Humerus Shaft Fracture for Data Collection of Healing Process, Quality of Life and Shoulder Function According to the Treatment Method - Hanover Humerus Register (HHR)
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Update on the efficacy and safety of intravenous tranexamic acid in hip fracture surgery: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Treatment of isolated greater tuberosity fractures: a scoping review.JSES reviews, reports, and techniques · 2026Review
- Current Evidence and Surgical Strategies in the Management of Greater Tuberosity Fracture-Dislocations: A Narrative Review.Journal of clinical medicine · 2025Review
- Risk factors associated with secondary displacement in fractures of the humeral greater tuberosity.Frontiers in surgery · 2025Article
- Management of greater tuberosity fracture dislocations of the shoulder.JSES reviews, reports, and techniques · 2024Review
- Article
- Fact or fiction: the "5 mm Rule" in greater tuberosity fractures of the proximal humerus.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIsolated greater tuberosity fractures are uncommon and account for approximately 2-19% [Emerg Radiol. 2018;25(3):235-246] of all proximal humerus fractures. Surgical treatment is the prevailing recommendation in cases of displacement of more than 5 mm for the general healthy population, while conservative treatment is considered to result in inferior outcomes and is not recommended. However, high-grade evidence is lacking for these recommendations.
methodsTwenty patients with conservatively treated isolated greater tuberosity fracture were evaluated prospectively as part of a registry study. Morphological Mutch classification, displacement in millimeters, and direction of displacement were determined by computed tomography (CT). Degree of fragment displacement was classified (nondisplaced to minor: ≤ 5 mm; moderate: 6-10 mm; major: > 10 mm). Constant score (CS), age- and sex-adjusted Constant score (adj. CS), subjective shoulder value (SSV), and radiographic follow-up were compared at a minimum follow-up of 12 months. For statistical analysis, quantitative data were compared using Mann-Whitney U t-test. Statistical significance was set at p ≤ 0.05.
resultsNinteen patients reached the minimum follow-up at an average of 19 months (range, 12-35 months). 13 patients were women. Average age at the time of injury was 51 years (range, 22-75 years). CS and adj. CS averaged 79 ± 17.5 points, and 91 ± 17.7 points, respectively. The SSV averaged 87 ± 17%. No statistically significant difference in clinical outcomes could be observed with respect to the degree of displacement among the three groups.
conclusionThe outcomes of conservatively treated displaced isolated greater tuberosity fractures are underestimated, and current indications for surgical treatment should be questioned. Further studies with larger numbers of patients and longer lengths of follow-up are needed. The protocol of this observational study is registered at ClinicalTrials.gov (NCT03060876). Date of registration: June 8, 2016.
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