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Surgery versus Nonoperative Management of 3–4-Part Proximal Humerus Fractures in Older Adults
August 2025
Surgery versus Nonoperative Management of 3–4-Part Proximal Humerus Fractures in Older Adults
Study Type:Therapy
OE Level Evidence:1
Journal Level of Evidence:1
Surgery with locking plate or hemiarthroplasty versus nonoperative treatment of 3-4-part proximal humerus fractures in older patients (NITEP): An open-label randomized trial.
PLoS Med . 2023 Nov 28;20(11):e1004308.Did you know you're eligible to earn 0.5 CME credits for reading this report? Click Here
Synopsis
One hundred sixty patients aged 60 years and older with displaced 3- or 4-part proximal humerus fractures were randomized to receive nonoperative treatment (n=54), locking plate fixation (n=52), or hemiarthroplasty (n=54). The primary outcome of interest was the DASH score at 2 years. Secondary outcomes included Constant–Murley Score, Oxford Shoulder Score, quality-of-life measures (EQ-5D and 15D)...
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