ArticleJSES international2026
Reverse shoulder arthroplasty for acute Neer type III and IV proximal humeral head fractures with different humeral stem inclination versus nonsurgical treatment: a prospective, single-blinded, randomized controlled trial.
Article in JSES international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The optimal treatment of proximal humeral head fractures is controversial. Recently, reverse total shoulder arthroplasty (rTSA) has gained expanding popularity in treating PHFs. The aim of this study is to compare outcomes of 2 differently designed rTSAs versus nonoperative treatment in patients with Neer type III or IV PHFs. Methods: This randomized controlled trial compares the outcomes in patients with acute complex PHFs treated nonoperatively versus rTSA. Subgroups differ in inclination of the humeral neck-shaft-angle, 135° versus 155°. Patients 60 to 90 years of age with PHFs were allocated and block-randomized in this trial. The primary outcome is the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) at 1 year; secondary outcomes include Constant Murley score (CMS) in total and adjusted, subjective shoulder value (SSV), Disabilities of Arm, Shoulder and Hand (DASH), and elevation. Radiographs had been evaluated to state union/displacement or resorption of the fracture. The rate of healing of the tuberosities in the surgical group has been defined. Results: We included 40 nonoperative patients versus 40 rTSA patients; at 1 year, 35 versus 30 patients were analyzed. There was no significant difference between the groups in terms of age, gender, or fracture type. The mean age was 72.9 years, and 89% were female. At 1 year, the WOOS score was 56.2 (SD 23.4) in the nonoperative group versus 76.9 (SD 19.3) in the rTSA group ( Conclusion: For Neer type III or IV (AO type B and C) proximal humeral head fractures in patients aged above 60 years, rTSA showed both clinically relevant and statistically significant superior outcomes compared with nonoperative treatment. Anatomical neck/shaft inclination of 135° was superior to HI 155°.
Indexed as
Identifiers
What OpenQuestion holds
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.