Evidence map›Paper›PMID 37300588›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023

How do surgeons decide when to treat proximal humerus fractures with operative versus nonoperative management?

Logan A Reed, Kevin A Hao, David A Patch, Joseph J King, Catherine Fedorka, Jaimo Ahn, Jason A Strelzow, Jonah Hebert-Davies, Milton T M Little, Peter C Krause and 2 more

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In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Long-term functional outcomes of Aequalis fracture hemiarthroplasty for proximal humerus fracture: a retrospective case series.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Article
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

12 authors at 8 institutions in 1 country.

Logan A ReedDepartment of Orthopaedic Surgery, University of Alabama, 510 20th St South, Faculty Office Tower, Birmingham, AL, 35294, USA. loganreed1994@gmail.com.ORCID http://orcid.org/0000-0002-9145-7668
Kevin A HaoUniversity of Florida College of Medicine, University of Florida, Gainesville, FL, USA.
David A PatchDepartment of Orthopaedic Surgery, University of Alabama, 510 20th St South, Faculty Office Tower, Birmingham, AL, 35294, USA.
Joseph J KingDepartment of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
Catherine FedorkaCooper Bone and Joint Institute, Cooper Medical School at Rowan University, Camden, NJ, USA.
Jaimo AhnDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Jason A StrelzowDepartment of Orthopaedic Surgery, The University of Chicago, Chicago, IL, USA.
Jonah Hebert-DaviesDepartment of Orthopedic Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Milton T M LittleDepartment of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Peter C KrauseDepartment of Orthopaedic Surgery, Louisiana State University School of Medicine, New Orleans, LA, USA.
Joseph P JohnsonDepartment of Orthopaedic Surgery, University of Alabama, 510 20th St South, Faculty Office Tower, Birmingham, AL, 35294, USA.
Clay A SpitlerDepartment of Orthopaedic Surgery, University of Alabama, 510 20th St South, Faculty Office Tower, Birmingham, AL, 35294, USA.
University of Alabama at Birmingham · USUniversity of Florida · USCedars-Sinai Medical Center · USCooper Medical School of Rowan University · USLouisiana State University · USUniversity of Chicago · USUniversity of Michigan · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe objective of this study was to determine the underlying factors that drive the decision for surgeons to pursue operative versus nonoperative management for proximal humerus fractures (PHF) and if fellowship training had an impact on these decisions.

methodsAn electronic survey was distributed to members of the Orthopaedic Trauma Association and the American Shoulder and Elbow Surgeons Society to assess differences in patient selection for operative versus nonoperative management of PHF. Descriptive statistics were reported for all respondents.

resultsA total of 250 fellowship trained Orthopaedic Surgeons responded to the online survey. A greater proportion of trauma surgeons preferred nonoperative management for displaced PHF fractures in patients over the age of 70. Operative management was preferred for older patients with fracture dislocations (98%), limited humeral head bone subchondral bone (78%), and intraarticular head split (79%). Similar proportions of trauma surgeons and shoulder surgeons cited that acquiring a CT was crucial to distinguish between operative and nonoperative management.

conclusionWe found that surgeons base their decisions on when to operate primarily on patient's comorbidities, age, and the amount of fracture displacement when treating younger patients. Further, we found a greater proportion of trauma surgeons elected to proceed with nonoperative management in patients older than the age of 70 years old as compared to shoulder surgeons.

Indexed as

Humeral FracturesShoulder FracturesSurgeonsAgedFracture Fixation, InternalHumansHumeral HeadHumerusSurveys and QuestionnairesTreatment OutcomeElbowFractureManagementProximal humerusShoulderTrauma

Identifiers

PMID37300588
OpenAlexW4379983101

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.