Trial reportInternational orthopaedics2021
Displaced three and four part proximal humeral fractures: prospective controlled randomized open-label two-arm study comparing intramedullary nailing and locking plate.
Trial report in International orthopaedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses 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
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Comparative efficacy and safety of medical treatments for proximal humerus fractures: a systematic review and network meta-analysis.BMC musculoskeletal disorders · 2024Pooled it
- Quality of Life and Pain after Proximal Humeral Fractures in the Elderly: A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Interventions for treating proximal humeral fractures in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Cost-effectiveness analysis of locking nail compared with locking plate for displaced 3- and 4-part proximal humerus fractures: a secondary analysis of a randomized trial comparing the Multiloc nail and PHILOS plate.Acta orthopaedica · 2025Trial
- Outcomes After Minimally Invasive Intramedullary Nail Fixation and Locking Plate Fixation Among Patients With Proximal Humerus Fractures.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Biomechanical Behavior of Composite Bone-Osteosynthesis Constructs in Complex Proximal Humerus Fractures: A Synergistic Experimental and Finite Element Approach.Bioengineering (Basel, Switzerland) · 2026Article
- Evaluating the fragility and robustness of randomized controlled trials in proximal humerus fracture management.JSES international · 2026Review
- Randomized controlled trials investigating proximal humerus fractures lack consensus in inclusion criteria.JSES reviews, reports, and techniques · 2025Article
- Clinical outcomes following intramedullary nailing of humerus fractures: a systematic review.JSES international · 2025Review
- Enhanced Biomechanical Stability in Proximal Humeral Fractures: Finite Element Analysis of a Novel Endosteal Anatomical Support Nail for Improved Fixation in Elderly Patients.Orthopaedic surgery · 2025Article
- Comparative analysis of adolescent intramedullary nailing and locking plate fixation for femoral shaft fractures.Frontiers in surgery · 2025Article
- Review
- Intramedullary Nail for Treatment of Proximal Humeral Fracture: A Credible Fixation in Comminuted Calcar.Orthopaedic surgery · 2023Article
- The effect of integrity of lesser tuberosity-medial calcar on postoperative outcome in the proximal humeral fracture.Journal of orthopaedic surgery and research · 2023Article
- Comment on the article by Boyer et al.: Displaced three- and four-part proximal humeral fractures: prospective controlled randomized open label two-arm study comparing intramedullary nailing and locking plate.International orthopaedics · 2022Article
- Different treatments for 3- or 4-part proximal humeral fractures in the elderly patients: A Bayesian network meta-analysis of randomized controlled trials.Frontiers in surgery · 2022Review
- Position statement: management of proximal humerus fractures.Canadian journal of surgery. Journal canadien de chirurgieReview
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was (1) to compare clinical and radiological outcomes of 3- and 4-part proximal humeral fractures using either IMN or LP (2) and to report complications related to each technique.
methodsA prospective controlled randomized open-label two-arm study was performed. Ninety-nine consecutive adult patients with a 3- and 4-part displaced acute proximal humeral fractures were randomized to be treated with IMN (n = 49) or LP (n = 50). Constant, ASES and SST scores were recorded by the surgeon. Range of motion was evaluated. A visual analog scale (VAS) was used to assess shoulder pain. Complications and revision surgeries were reported.
resultsEighty-five patients were analyzed, nine were lost, and five died during the follow-up period. The mean age was 73.7 years (± 13.3,, and the mean follow-up was 66 months (± 13.5). At last follow-up, VAS was lower in the IMN group (0.9 (± 1.1) vs. 1.9 (± 1.7), p = 0.001). The median Constant score was significantly higher in the IMN group (81.6 (± 10.9) points) vs. in the LP group (75.6 (± 19.5) points) (p = 0.043), and ASES score was also significantly higher in the IMN group (86.3 (± 9.5) vs. 75.2 (± 19.6), p = 0.001). There was no difference in the range of motion or SST scores between the two groups. Complications were seen higher in the LP group (9 (21%) vs. 22 (52%), p = 0.003). Revision surgery was higher in the LP group (37% vs. 21%).
conclusionSatisfactory results were accomplished in both groups according to the reported clinical outcomes. Complication and revision rates were higher in LP group.
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