ArticleJournal of clinical medicine2023
Proximal Humerus Fractures in the Elderly U.S. Population: A Cross-Sectional Study of Treatment Trends and Comparison of Complication Rates after Joint Replacement, Open Reduction and Internal Fixation, and Non-Surgical Management.
Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Reverse total shoulder arthroplasty versus locked plate fixation for proximal humeral fractures in the elderly: a systematic review.PloS one · 2025Pooled it
- Corrective osteotomies of malunited proximal humerus fractures with 3D patient-specific guides: a feasibility study.JSES international · 2026Article
- Analysis of factors associated with persistent night pain after locking plate fixation of proximal humerus fractures and development of a prediction model.BMC musculoskeletal disorders · 2026Observational
- Use of locking humeral stems in reverse total shoulder arthroplasty for complex proximal humerus fractures: a scoping review.JSES reviews, reports, and techniques · 2026Review
- Management of a proximal humerus nonunion with an extramedullary calcar replacing iliac crest autograft: surgical technique and review of the literature.JSES reviews, reports, and techniques · 2026Article
- Progress in the treatment of complex osteoporotic proximal humeral fractures in elderly patients.Frontiers in surgery · 2026Review
- Article
- Proximal humerus fractures: Treatment controversies.OTA international : the open access journal of orthopaedic trauma · 2025Article
- Plate osteosynthesis versus non-surgical treatment in displaced proximal humerus fractures-long term functional outcome and quality of life.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Evaluation of the multiplex PCR combined with capillary electrophoresis technique for detecting pathogenic bacteria and antibiotic resistance genes in bone infections.BMC infectious diseases · 2025Article
- Treatment of Proximal Humeral Fractures in Older Patients During COVID-19 Pandemic in Germany.Clinical epidemiology · 2025Article
- Comparative outcomes of operative treatment for two and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns: intramedullary nail versus open reduction internal fixation.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- A clinical study on robot navigationassisted intramedullary nail treatment for humeral shaft fractures.BMC musculoskeletal disorders · 2024Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Proximal humerus fracture (PHF) treatment remains challenging. Multiple therapy options exist, and the optimal choice of management has been increasingly discussed in the literature. The aim of this study was to (1) analyze trends in the propensity of proximal humerus fracture treatments and (2) compare complication rates after joint replacement, surgical repair, and non-surgical treatment in terms of mechanical complications, union failure, and infection rates. In this cross-sectional study, patients aged 65 years or older with proximal humerus fractures occurring between 1 January 2009 and 31 December 2019 were identified from Medicare physician service claims records. The Kaplan-Meier method with the Fine and Gray adjustment was used to calculate the cumulative incidence rates for malunion/nonunion, infection, and mechanical complications for the following treatment categories: shoulder arthroplasty, open reduction and internal fixation (ORIF), and non-surgical treatment, respectively. Semiparametric Cox regression was performed incorporating 23 demographic, clinical, and socioeconomic covariates to determine risk factors. Between 2009 through 2019, conservative procedures decreased by 0.9%. ORIF procedures decreased from 9.51% (95% CI: 8.7-10.4) to 6.95% (95% CI: 6.2-7.7), whereas shoulder arthroplasties rose from 1.99% (95% CI: 1.6-2.4), to 5.45% (95% CI: 4.8-6.2). PHFs managed through ORIF were associated with higher union failure rates compared to conservatively treated fractures (HR = 1.31, 95% CI: 1.15-1.5,
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