Management of Proximal Humeral Fractures in Adults: A Systematic Review and Meta-Analysis.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2023;11(9):8 J Orthop Trauma . 2023 Feb 1;37(2):e80-e88.What this means for my practice?
Overall, no significant differences were reported between operative and nonoperative treatments with respect to function, pain, and incidence of reoperation. ORIF versus nonoperative treatment showed lower reoperation rates in the nonoperative group. The results of this meta-analysis were limited by the quality of the evidence, small number of included studies, and the inability to pool some of the data.
Study Summary
In this meta-analysis, fifteen randomized controlled trials were included to compare operative (ORIF with locked plates, locked IMN, cemented, uncemented, nonmodular or modular hemiarthroplasty, and reverse shoulder arthroplasty) versus non-operative treatment for proximal humeral fractures. Outcomes of interest were normalized function, pain on the Visual Analog Scale (VAS), and the incidence of reoperation. In the pooled analysis comparing operative treatment with nonoperative treatment, no differences were found between all outcomes. When comparing ORIF with non-operative treatments, no differences were found with respect to function and pain, but reoperation rates favored the non-operative treatment group.
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