Evidence map›Paper›PMID 42113319›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026

Does the operative technique (MIPO vs. ORIF) influence surgical outcomes and complications in proximal humerus fractures? A matched-pair analysis.

Christiane Barthel, Franziska Rudolph, Moritz Kraus, Yannik Kalbas, Rodd Russek, Hans-Christoph Pape, Florin Allemann

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Clinical validation of the DRoPH score: a preoperative tool for estimating reduction difficulty in proximal humerus fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    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

7 authors.

Christiane BarthelDepartment of Shoulder and Elbow Surgery, Schulthess Klinik, Lengghalde 2, Zurich, CH-8008, Switzerland. christiane.barthel@kws.ch.
Franziska RudolphDepartment of Traumatology, University Hospital Zurich, Zurich, Switzerland.
Moritz KrausDepartment of Shoulder and Elbow Surgery, Schulthess Klinik, Lengghalde 2, Zurich, CH-8008, Switzerland.
Yannik KalbasHarald-Tscherne Laboratory of Orthopedic and Trauma Research, University Hospital Zurich, Zurich, Switzerland.
Rodd RussekHarald-Tscherne Laboratory of Orthopedic and Trauma Research, University Hospital Zurich, Zurich, Switzerland.
Hans-Christoph PapeDepartment of Traumatology, University Hospital Zurich, Zurich, Switzerland.
Florin AllemannDepartment of Traumatology, University Hospital Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionProximal humerus fractures account for approximately 4-6% of all fractures and are among the most common fractures in the elderly. Surgical treatment is increasingly applied for displaced and unstable fracture patterns. The two most commonly used techniques are open reduction and internal fixation (ORIF) via a deltopectoral approach and minimally invasive plate osteosynthesis (MIPO) using a deltoid-split or anterolateral approach. ORIF allows direct fracture visualization and anatomical reduction but is associated with more extensive surgical exposure. MIPO aims to preserve soft tissues and vascular supply through indirect reduction techniques. This study compares ORIF and MIPO in proximal humerus fractures with regard to surgical parameters, radiographic outcomes, and complications.

methodsA retrospective single-center cohort of 392 proximal humerus fractures was analyzed. Seventy-nine patients treated with MIPO were matched to 79 patients treated with ORIF using exact matching for fracture type (Mayo FJD classification) and propensity score matching for age and sex. Primary outcomes included operative time, reduction quality, and complication rates.

resultsThe MIPO group showed significantly shorter operative times (97.3 ± 30.8 min vs. 112.2 ± 34.0 min, p = 0.004). No significant differences were observed in reduction quality or overall complication rates (MIPO 19.0% vs. ORIF 21.5%). However, functional complications and implant malpositioning showed a non-significant trend toward higher rates in the MIPO group, while hardware-related complications were more frequently observed in the ORIF group.

conclusionOur findings support MIPO as a valuable alternative to ORIF for proximal humerus fractures, offering reduced operative time without compromising reduction quality or complication rates. Patient selection, fracture complexity, and surgeon experience should guide technique choice. Appropriate training remains essential, and future prospective studies incorporating functional outcome measures are warranted. LEVEL OF EVIDENCE: Level III, retrospective matched-pair-study.

Indexed as

Fracture Fixation, InternalMinimally Invasive Surgical ProceduresOpen Fracture ReductionPostoperative ComplicationsShoulder FracturesAgedAged, 80 and overBone PlatesFemaleHumansMaleMatched-Pair AnalysisMiddle AgedOperative TimePropensity ScoreRetrospective StudiesDRoPH ScoreMIPO, open reduction and internal fixationOperative timeProximal humerus fractureReduction quality

Identifiers

PMID42113319
PMCPMC13672671

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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.