ArticleBone & joint research2023
Proximal humerus fractures - epidemiology, comparison of mortality rates after surgical versus non-surgical treatment, and analysis of risk factors based on Medicare registry data.
Article in Bone & joint research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Comparison between arthroplasty and non-operative treatment for proximal humeral fractures: a systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- Osteoporosis medication initiation after proximal humerus fractures is low, but associated with decreased secondary fragility fracture risk.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Proximal humerus fractures treated with a modified palm tree technique.Musculoskeletal surgery · 2026Article
- Radiographic Assessment of Glenoid Morphology and Its Association with Proximal Humeral Fracture Configuration.Journal of clinical medicine · 2026Article
- In older adults undergoing surgical fixation or arthroplasty following upper limb fractures, does frailty predict post-operative complications and mortality? A systematic review and meta-analysis.JSES reviews, reports, and techniques · 2026Review
- Influence of allograft augmentation on surgical outcomes and complications in proximal humerus fractures: a matched-pair analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Clinical analysis of preoperative and postoperative anxiety and depression in patients with proximal humeral fractures.BMC psychology · 2026Article
- Article
- Staged reverse shoulder arthroplasty with structural allograft-prosthesis composite and lower trapezius tendon transfer for massive proximal humeral bone loss following gunshot injury: a case report.Journal of surgical case reports · 2026Article
- Mortality in patients over 65 with proximal humerus fractures: a systematic review of 414,379 shoulders with meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Regional anesthesia strategies for proximal humerus fracture surgery: anatomical considerations, diaphragm-sparing techniques, and expert perspectives-a narrative review.Langenbeck's archives of surgery · 2026Review
- Article
- Association of perineural hydromorphone added to ropivacaine with early analgesic outcomes in proximal humerus fracture surgery: a retrospective cohort study.Frontiers in medicine · 2026Article
- Comparison of three reconstruction techniques for medial column support loss in elderly patients with proximal humeral fractures.Frontiers in medicine · 2026Article
- Major Upper-Extremity Fractures in Older Adults: Predictors of 5-Year Mortality.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- Association Between Non-Operative versus Operative Management and Mortality in Elderly Patients with Hip Fracture: A Retrospective Cohort Study.Clinical interventions in aging · 2026Article
- Randomized controlled trials investigating proximal humerus fractures lack consensus in inclusion criteria.JSES reviews, reports, and techniques · 2025Article
- Increased all-cause mortality following proximal humerus fractures in Danish adults: a register-based matched cohort study of 93,952 fracture cases and 469,760 controls.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Helical plating yields better outcomes than intramedullary nailing or long straight lateral plating for humeral shaft fractures extending to the proximal humerus.Journal of orthopaedic surgery and research · 2025Article
- 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 · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe optimal choice of management for proximal humerus fractures (PHFs) has been increasingly discussed in the literature, and this work aimed to answer the following questions: 1) what are the incidence rates of PHF in the geriatric population in the USA; 2) what is the mortality rate after PHF in the elderly population, specifically for distinct treatment procedures; and 3) what factors influence the mortality rate?
methodsPHFs occurring between 1 January 2009 and 31 December 2019 were identified from the Medicare physician service records. Incidence rates were determined, mortality rates were calculated, and semiparametric Cox regression was applied, incorporating 23 demographic, clinical, and socioeconomic covariates, to compare the mortality risk between treatments.
resultsFrom 2009 to 2019, the incidence decreased by 11.85% from 300.4 cases/100,000 enrollees to 266.3 cases/100,000 enrollees, although this was not statistically significant (z = -1.47, p = 0.142). In comparison to matched Medicare patients without a PHF, but of the same five-year age group and sex, a mean survival difference of -17.3% was observed. The one-year mortality rate was higher after nonoperative treatment with 16.4% compared to surgical treatment with 9.3% (hazard ratio (HR) = 1.29, 95% confidence interval (CI) 1.23 to 1.36; p < 0.001) and to shoulder arthroplasty with 7.4% (HR = 1.45, 95% CI 1.33 to 1.58; p < 0.001). Statistically significant mortality risk factors after operative treatment included age older than 75 years, male sex, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, chronic kidney disease, a concomitant fracture, congestive heart failure, and osteoporotic fracture.
conclusionMortality risk factors for distinct treatment modes after PHF in elderly patients could be identified, which may guide clinical decision-making.Cite this article:
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