24 papers · updated 2026-09-26 · Shoulder & Elbow · All topics
The newest papers on proximal humerus fractures from the orthopaedic journals The Reduction reads, newest first, each with a one-line summary. The list is drawn from the digest’s archive and refreshed every week.
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Neer classification predicts 10-year outcomes in nonoperatively treated proximal humeral fractures; AO classification does not correlate with function.
At 7-year follow-up, reverse shoulder arthroplasty provided better functional outcomes than nonoperative treatment for displaced 3- or 4-part proximal humerus fractures in patients over 80.
In 64 patients with rTSA for proximal humerus fractures, pain relief and function were largely achieved by one year, with only modest further gains by two years, supporting one-year outcomes as sufficient for most patients.
Combined proximal humerus and femur fragility fractures required roughly twice the hospital stay of isolated humerus fractures but showed similar one-year mortality and readmission rates, suggesting benefit from shared orthogeriatric pathways.
Adding latissimus dorsi transfer to lateralized reverse shoulder arthroplasty did not improve external rotation or functional scores over rTSA alone but caused significantly more early proximal humeral bone erosion.
After proximal humerus fracture fixation, physician-rated Constant-Murley scores systematically diverged from patient-rated subjective shoulder values, with pain—not motion or strength—driving poor patient-reported outcomes.
The pectoralis major reference technique improved tuberosity healing, humeral height restoration, and rotational function compared to conventional technique in hemiarthroplasty for complex proximal humeral fractures.
A horizontal plate fixation technique for isolated greater tuberosity fractures achieved reliable union and good UCLA shoulder scores in 11 patients.
In a national trauma registry, reverse shoulder arthroplasty for proximal humerus fracture showed no significant difference in adjusted in-hospital outcomes versus hemiarthroplasty, except higher non-home discharge risk in patients under 65.
In elderly patients with complex proximal humerus fractures, cement-augmented locking plate fixation gave better rotation than reverse shoulder arthroplasty, with similar overall function, complications, and revision rates.
In 141 proximal humerus fracture ORIF cases, dual-plate constructs had significantly fewer reoperations, varus cutouts, and nonunions than single-plate fixation, especially benefiting high-energy fractures.
3D convolutional neural network accurately classified proximal humerus fractures and characterized greater tuberosity displacement and varus malalignment on CT, with performance comparable to surgeons for these key features.
Tuberosity Management in Reverse Shoulder Arthroplasty for Proximal Humerus Fractures.
This review discusses indications, implant choices, and techniques for tuberosity management during reverse shoulder arthroplasty for proximal humerus fractures to optimize functional outcomes.
Contemporary Management of Proximal Humeral Fractures.
This review covers current nonsurgical and surgical options—including fixation and reverse shoulder arthroplasty—for managing proximal humerus fractures.
A Delphi consensus among ASES shoulder experts found agreement on surgery for certain complex proximal humerus fractures in healthy patients and nonoperative care in sicker patients, but no consensus on rehabilitation protocols or many fracture patterns.
Proximal Humerus Reconstruction in Skeletally Immature Patients.
Proximal humerus reconstruction in skeletally immature patients requires balancing multiple factors; expandable prostheses and vascularized transfers address unique growth-related challenges.
This review covers evaluation and management of pediatric proximal humerus tuberosity avulsion fractures, noting sparse evidence and unclear treatment guidelines for these rare, easily missed injuries.
Reverse Shoulder Arthroplasty to Treat Proximal Humerus Fracture Sequelae: A Review.
Reviews reverse shoulder arthroplasty as an effective salvage option for painful proximal humerus fracture malunions/nonunions, highlighting outcome classification and technical pearls for tuberosity management.
Technical Tips for Reduction and Stable Fixation of Proximal Humerus Fractures.
Technical innovations including fibular strut allograft, calcar screw placement, and systematic reduction improve outcomes in proximal humerus fracture fixation.
International consensus for a core radiological monitoring protocol of proximal humerus fractures.
An international Delphi consensus among shoulder trauma surgeons established a standardized radiological monitoring protocol—including a redefined 'malreduction' term and recommended imaging views/timing—for tracking proximal humerus fracture healing.
Reviews evidence supporting reverse total shoulder arthroplasty as an effective option for complex proximal humerus fractures and failed repairs in patients ≥65, though higher-quality data are still needed.
Principles of Locking Plate Fixation of Proximal Humerus Fractures.
This review outlines anatomic and biomechanical principles for locked plate fixation of proximal humerus fractures, emphasizing screw placement and augmentation strategies to prevent fixation failure.
Intramedullary Fixation for Proximal Humeral Fractures.
Intramedullary nailing of proximal humeral fractures offers biomechanical and vascular preservation advantages, especially with calcar comminution, with outcomes comparable to plating.
Posttraumatic avascular necrosis occurs after femoral neck, humeral head, talar neck, and scaphoid fractures; diagnosis timing and treatment depend on specific anatomic location and collapse.
Displaced Proximal Humeral Fractures
This classic paper introduces the Neer four-segment classification of displaced proximal humeral fractures based on displacement of the head, tuberosities, and shaft, along with a results-rating scale.
Displaced Proximal Humeral Fractures
In 117 displaced three- and four-part proximal humeral fractures, open reduction was best for three-part fractures while prosthetic replacement was preferred for four-part fractures due to avascular necrosis risk.
Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus
Short metaphyseal extension (<8mm calcar), disrupted medial hinge, and specific fracture patterns reliably predict humeral head ischemia after proximal humerus fractures.
Tuberosity malposition and migration after proximal humerus hemiarthroplasty correlate with unsatisfactory outcomes; improved fixation techniques should enhance predictable results.
The Importance of Medial Support in Locked Plating of Proximal Humerus Fractures
In locked plating of proximal humerus fractures, medial column support (anatomic reduction, impaction, or an inferomedial screw) significantly reduced loss of reduction and screw penetration compared to fractures lacking such support.
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