Evidence map›Paper›PMID 41179442›Full record

ArticleJSES reviews, reports, and techniques2025

Randomized controlled trials investigating proximal humerus fractures lack consensus in inclusion criteria.

Cailan L Feingold, Justin Castonguay, Eric H Lin, Andrew B Barcenas, Jacob L Kotlier, Meng-Yung Ong, Joseph Mixa, Ioanna K Bolia, Joseph N Liu

Abstract read
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In one paragraph

Article in JSES reviews, reports, and techniques, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Cailan L FeingoldDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Justin CastonguayDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Eric H LinDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Andrew B BarcenasDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Jacob L KotlierDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Meng-Yung OngDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Joseph MixaDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Ioanna K BoliaDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Joseph N LiuDepartment of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: This study aimed to investigate inclusion and exclusion criteria for subjects of randomized control trials (RCTs) studying operative management of proximal humerus fractures (PHFs) and to define the presence or absence of objectivity and consensus among these inclusion and exclusion criteria of these studies. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Web of Science, and Scopus were queried from inception to September 1, 2023, for RCTs studying PHFs. Studies were included if they investigated operative management of PHFs, had defined inclusion and exclusion criteria, were published in the English language, and were in peer-reviewed journals. RCTs were excluded if they were investigating only nonoperative management of PHFs. The inclusion and exclusion criteria were extracted from these studies and compared using descriptive statistics following study screening. Results: A total of 42 RCTs met the inclusion criteria, of which 9 investigated surgical vs. conservative management and 33 compared surgical techniques. The Neer fracture classification system was utilized most frequently in 30 (71.4%) studies in fracture pattern description. Only 8 studies defined the direction of angulation and 3 defined the ratio of displacement of the shaft with relation to the head. Injury chronicity and mechanism were rarely included (21.4% and 19.0%, respectively). Most (73.9%) included age within their inclusion and exclusion criteria. Other patient-specific factors including sex and baseline function/independence were scarce. Conclusion: In RCTs studying PHFs, most studies rely on fracture pattern classification systems to describe inclusion and exclusion criteria, but these fail to objectively delineate which fractures should be included. Few studies include additional elements to improve objectivity of fracture pattern characterization. Besides age, most RCTs on surgical management of PHFs do not include patient-specific variables within their inclusion and exclusion criteria.

Indexed as

Exclusion criteriaInclusion criteriaProximal humerus fractureProximal humerus fracture classificationRandomized controlled trialRandomized controlled trial criteria

Identifiers

PMID41179442
PMCPMC12573612

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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.