Evidence map›Paper›PMID 35141688›Full record

ArticleJSES international2022

Trending a decade of proximal humerus fracture management in older adults.

Akshar H Patel, J Heath Wilder, Sione A Ofa, Olivia C Lee, Felix H Savoie, Michael J O'Brien, William F Sherman

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JSES international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 4 pooled it
12.1field-weighted citation impact, top 1% of its field
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

54 citing papers in PubMed, 4 syntheses or guidelines pooled it, 88 citations in OpenAlex.

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  17. Changing Demographic and Treatment Trends of Proximal Humerus Fractures: A TriNetX Analysis of 74,781 Patients.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
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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

7 authors at 1 institution in 1 country.

Akshar H PatelDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
J Heath WilderDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Sione A OfaDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Olivia C LeeDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Felix H SavoieDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Michael J O'BrienDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
William F ShermanDepartment of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
Tulane University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProximal humerus fractures are the third most common fracture in older adults. Because of the aging population, the incidence of these fractures and their impact will continue to grow. With advancement in treatment options for proximal humeral fractures, the aim of this study was to evaluate the trends in acute management of proximal humerus fractures to determine how definitive treatment has changed over the past decade in patients older than 65 years.

methodsUsing a commercially available database, patient records were queried from 2010 to 2019 for the incidence of proximal humerus fractures. For each individual year, data were queried to identify the incidence of closed reduction percutaneous pinning (CRPP), hemiarthroplasty (HA), intramedullary nailing (IMN), open reduction internal fixation (ORIF), total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RSA), or nonoperative treatment for acute proximal humeral fractures. A Cochran-Armitage trend test was used to determine significant changes in the trends of proximal humerus fracture management. Logistic regression analyses were performed to generate odds ratios (OR) with associated 95% confidence intervals comparing each individual procedure performed in 2019 to 2010.

resultsA total of 160,836 patients at least 65 years of age and older were diagnosed with a proximal humerus fracture. Of this total, 28,503 (17.72%) patients received operative treatment and 132,333 (82.28%) received nonoperative treatment. From 2010 to 2019, operative treatment trends of proximal humerus fractures changed such that CRPP decreased by 60.0%, HA decreased by 81.4%, IMN decreased by 81.9%, ORIF decreased by 25.7%, TSA decreased by 80.5%, and RSA increased by 1841.4% (all

conclusionOver the past decade, most of older adults who sustain proximal humerus fractures continue to receive nonoperative treatment. Although CRPP, IMN, HA, ORIF, and TSA have decreased, RSA has recently become more widely utilized, which is consistent with what has been noted in other countries. Continued examination of the mid- and long-term outcomes of the increasing percentages in RSA should be performed in this population.

Indexed as

ElderlyHemiarthroplastyInternal fixationProximal humerus fractureReverse shoulder arthroplastyTotal shoulder arthroplasty

Identifiers

PMID35141688
PMCPMC8811391
OpenAlexW3206052607

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.