ReviewCurrent reviews in musculoskeletal medicine2023
Plate Fixation of Proximal Humerus Fractures: How to Get It Right and Future Directions for Improvement.
Review in Current reviews in musculoskeletal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses 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
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Immediate reverse shoulder arthroplasty demonstrates better outcomes than salvage reverse shoulder arthroplasty for proximal humerus fractures in the elderly: a meta-analysis.Journal of orthopaedic surgery and research · 2026Pooled it
- Reverse total shoulder arthroplasty versus locked plate fixation for proximal humeral fractures in the elderly: a systematic review.PloS one · 2025Pooled it
- Retrospective study comparing first- and new-generation proximal humerus locking plates in 152 proximal humerus fracture cases.JSES reviews, reports, and techniques · 2026Article
- Article
- 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
- Article
- Clinical analysis of preoperative and postoperative anxiety and depression in patients with proximal humeral fractures.BMC psychology · 2026Article
- Comparative Assessment of Proximal Humeral Bone Density Using CT Osteoabsorptiometry, Bone Microarchitecture Analysis, and a HU-Based Calibration Method: A CT and Micro-CT Study in Elderly Body Donors (65-86 Years).Diagnostics (Basel, Switzerland) · 2026Article
- Fluoroscopic Evaluation of Reduction and Plate Positioning in Proximal Humerus Fractures: A Case-Control Study Comparing CFR-PEEK and Metallic Plates.The archives of bone and joint surgery · 2026Article
- Progress in the treatment of complex osteoporotic proximal humeral fractures in elderly patients.Frontiers in surgery · 2026Review
- Minimally invasive percutaneous cannulated screw fixation for pelvic fractures: a retrospective case cohort study of clinical and radiological outcomes.Frontiers in medicine · 2026Article
- Triceps-sparing versus triceps-splitting approaches for OTA 12A-C and 13A2-3 distal-third humeral shaft fractures have similar 1 year functional outcomes.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Preventing reduction loss following proximal humerus fractures after locking compression plate fixation: a new clinical prediction model.BMC musculoskeletal disorders · 2025Article
- Assessment of humeral head perfusion after proximal humeral fracture - study protocol for evaluation of MR-based imaging techniques.Journal of orthopaedic surgery and research · 2025Article
- Comparative analysis of adolescent intramedullary nailing and locking plate fixation for femoral shaft fractures.Frontiers in surgery · 2025Article
- Analysis and optimization of inpatient cost structure for fracture patients under the implementation of the DRG policy.Frontiers in public health · 2025Article
- [Research progress on valgus impacted proximal humeral fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- Three- or four-part proximal humeral fractures in middle-aged and active elderly group of patients: a narrative review of treatment options.Annals of joint · 2024Review
- Cyclic Stability of Locking Plate Augmented with Intramedullary Polymethyl Methacrylate (PMMA) Strut Fixation for Osteoporotic Humeral Fractures: A Biomechanical Study.Life (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purpose of reviewOpen reduction and internal fixation with locking plates (ORIF-LP) has been used for decades for the surgical management of proximal humerus fractures. Despite good outcomes have been widely published in the literature, unacceptably high rates of complications (up to 40%), many of them yielding poor outcomes and requiring reoperation (up to 25%), have also been reported, especially in elderly patients. Most common complications are related to implant failure, with intra-articular screw penetration as the most frequent and devastating. RECENT
findingsAdvances in patient selection and surgical technique, and implementation of bone or cement augmentation, have been developed to hopefully decrease complication rates. Mayo-FJD Classification offers prognostic information that can aid in the decision-making process for proximal humeral fractures. Displaced valgus impacted fractures seem to be associated with well over a 10% rate of avascular necrosis after ORIF-LP. A principle-based and stepwise surgical technique combining anatomic reduction and a short screw configuration can provide good outcome in most patients, even the elderly, decreasing implant failures to less than 10%. Acrylic cement augmentation has the potential to further decrease implant failure rate to 1%. Reoperation rates are higher partly due to the need to remove hardware for painful subacromial conflict. However, no studies to date definitively demonstrated the superiority of ORIF-LP compared to non-operative treatment, intramedullary nailing, or reverse shoulder arthroplasty. ORIF-LP can provide good results for the surgical management of displaced proximal humerus fractures even in elderly patients provided adequate patient selection and a principle based and stepwise surgical technique, supplemented with bone graft or acrylic cement when needed. Poor outcomes and high complication and reoperation rates should be expected when these recommendations are not followed.
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Registered trials
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.