Evidence map›Paper›PMID 39549079›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024

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.

Zachariah Whiting, Lucas Haase, Tyler Moon, Akash Raju, Robert Wetzel, John Sontich, George Ochenjele, Josh Napora

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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. Article
  2. Review
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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

8 authors.

Zachariah WhitingDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. Zachariah.whiting@uhhospitals.org.ORCID http://orcid.org/0000-0003-3284-4606
Lucas HaaseDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
Tyler MoonDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
Akash RajuDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
Robert WetzelDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
John SontichDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
George OchenjeleDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
Josh NaporaDepartment of Orthopaedics, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate whether the outcomes, including union rates, complications, reoperations, blood loss, operative time, and range of motion, differed following intramedullary nailing (IMN) or open reduction internal fixation (ORIF) of two- and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns.

methodsThis was a retrospective multicenter study at three community centers and one level 1 trauma center. Inclusion criteria were two- and three-part proximal humerus fracture treated with either IMN or ORIF from 2015 to 2022 with at least three months of postoperative follow-up.

results228 patients. No significant differences in preoperative subject characteristics were observed. IMN was significantly more common with ipsilateral shaft fractures (p = 0.011). The number of fracture parts was significantly associated with treatment (p < 0.001). IMN had significantly less blood loss in two-part fractures (p = 0.016) and concomitant shaft fractures (p = 0.029), but operative time was not significantly less in any group. Union rates, complications, reoperation, postoperative humeral neck shaft angle, and postoperative range of motion were not significantly different.

conclusionsIMN and ORIF result in similar outcomes for proximal humerus fractures. Both treatments result in high union rates, the potential for near anatomic postoperative humeral neck shaft angles, and sufficient postoperative range of motion. IMN has lower blood loss than ORIF. IMN is a viable option for two-part proximal humerus fractures and may be effective in select three-part fractures as well. Concomitant humeral shaft fractures can be treated with either IMN or ORIF. Head-split patterns should be treated with ORIF.

Indexed as

Blood Loss, SurgicalFracture Fixation, IntramedullaryOpen Fracture ReductionOperative TimeRange of Motion, ArticularReoperationShoulder FracturesAdultAgedFemaleFracture HealingHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesHead-split patternIntramedullary nailIpsilateral shaft fractureOpen reduction internal fixationProximal humerus fracture

Identifiers

PMID39549079

What OpenQuestion holds

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Registered trials

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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.