A scoping review of the proximal humerus fracture literature

Abstract

BackgroundProximal humerus fractures are a common fragility fracture that significantly affects the independence of older adults. The outcomes of these fractures are frequently disappointing and previous systematic reviews are unable to guide clinical practice. Through an integrated knowledge user collaboration, we sought to map the breadth of literature available to guide the management of proximal humerus fractures.MethodsWe utilized a scoping review technique because of its novel ability to map research activity and identify knowledge gaps in fields with diverse treatments. Through multiple electronic database searches, we identified a comprehensive body of proximal humerus fracture literature that was classified into eight research themes. Meta-data from each study were abstracted and descriptive statistics were used to summarize the results.Results1,051 studies met our inclusion criteria with the majority of research being performed in Europe (64%). The included literature consists primarily of surgical treatment studies (67%) and biomechanical fracture models (10%). Nearly half of all clinical studies are uncontrolled case series of a single treatment (48%). Non-randomized comparative studies represented 12% of the literature and only 3% of the studies were randomized controlled trials. Finally, studies with a primary outcome examining the effectiveness of non-operative treatment or using a prognostic study design were also uncommon (4% and 6%, respectively).ConclusionsThe current study provides a comprehensive summary of the existing proximal humerus fracture literature using a thematic framework developed by a multi-disciplinary collaboration. Several knowledge gaps have been identified and have generated a roadmap for future research priorities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0564-8) contains supplementary material, which is available to authorized users.

Effectiveness of additional thoracic paravertebral block in improving anesthetic effects of regional anesthesia for proximal humeral fracture surgery in elderly patients: study protocol for a randomized controlled trial

“…Proximal humeral fracture accounts for 4% to 10% of all fractures occurring in the elderly population over 60 years, with the greatest incidence in women ages 80 to 89 years [1,2]. It is possible to affect the quality of life and related with high mortality [3]. The aged patients are commonly afflicted with severe cardiac or pulmonary co-morbidity, which may increase their perioperative risks.…”

Effectiveness of additional thoracic paravertebral block in improving anesthetic effects of regional anesthesia for proximal humeral fracture surgery in elderly patients: study protocol for a randomized controlled trial

“…Proximal humeral fractures account for 4% to 10% of all fractures occurring in the elderly population over 60 years, with the greatest incidence in women ages 80 to 89 years [1,2]. The fractures have the potential to affect the quality of life and associate with high rates of mortality [3]. The aged patients are commonly afflicted with severe cardiac or pulmonary co-morbidity, which may increase their perioperative risks.…”

A Report on Features of Three- and Four-Part Proximal Humeral Fractures and Outcome of Internal Fixation Using the Philos® Locking Plate

“…Proximal humerus fractures are largely considered to be osteoporosis-associated particularly affecting the active elderly as a result of minimal trauma [3]. As a result, these fractures have a substantial negative impact on the quality of life and independence of patients, as well as financial burden on health care systems [4]. Various surgical techniques have been proposed for fixation of comminuted and displaced proximal humeral fractures with the aim of proper restoration of a painless shoulder fulfilling patient's functional demands.…”