Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review
Background: Proximal humerus fractures (PHFs) occur most commonly in an elderly and osteoporotic population, but a considerable proportion of these injuries occur in relatively younger individuals. Differences in treatment principles and outcomes in this younger population remain poorly understood....
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | JSES Reviews, Reports, and Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639123000111 |
| _version_ | 1797837703336689664 |
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| author | Daniel J. Cognetti, MD Jonathan D. Hughes, MD Gregory R. Sprowls, MD Christine M. McDonough, PhD Soheil Sabzevari, MD Aaron E. Barrow, MD Albert Lin, MD |
| author_facet | Daniel J. Cognetti, MD Jonathan D. Hughes, MD Gregory R. Sprowls, MD Christine M. McDonough, PhD Soheil Sabzevari, MD Aaron E. Barrow, MD Albert Lin, MD |
| author_sort | Daniel J. Cognetti, MD |
| collection | DOAJ |
| description | Background: Proximal humerus fractures (PHFs) occur most commonly in an elderly and osteoporotic population, but a considerable proportion of these injuries occur in relatively younger individuals. Differences in treatment principles and outcomes in this younger population remain poorly understood. The purpose of this review was to characterize the treatment algorithms and outcomes for patients less than or equal to 60 years of age with PHFs. Methods: A comprehensive search of the Medline, Pubmed, Embase, and Cochrane databases for articles published between January 2005 and December 2020 was performed in January 2021. Levels of evidence I-IV analyzing outcomes (patient reported outcomes and/or complications) following PHFs in adult patients less than or equal to 60 years of age were included. The search was carried out in accordance with the preferred reported items for systematic reviews and meta-analyses guidelines. The risk of bias 2 tool and methodological index for nonrandomized studies score were utilized to evaluate included studies. Results: Fourteen studies met the inclusion criteria (open reduction internal fixation: 5, intramedullary nail: 4, hemiarthroplasty: 2, nonoperative: 1, and reverse total shoulder arthroplasty (RTSA): 1). Seven studies reported differences in outcomes between younger and older patient populations, with three studies noting separate management algorithms for those 60 years of age or younger. There were no studies comparing different treatments modalities in those less than 60 years of age, and the lone study on RTSA did not include patient-reported outcomes. Conclusion: Treatment algorithms and outcomes following PHFs in patients less than or equal to 60 years of age are distinctly different from that of a more elderly population. However, evidence-based treatment recommendations for this younger population are limited by the lack of studies comparing treatment modalities and the absence of patient-reported outcomes for individuals undergoing RTSA. |
| first_indexed | 2024-04-09T15:30:05Z |
| format | Article |
| id | doaj.art-59dfaac29d27440880de78fe8b6c516b |
| institution | Directory Open Access Journal |
| issn | 2666-6391 |
| language | English |
| last_indexed | 2024-04-09T15:30:05Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj.art-59dfaac29d27440880de78fe8b6c516b2023-04-28T08:56:38ZengElsevierJSES Reviews, Reports, and Techniques2666-63912023-05-0132142149Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic reviewDaniel J. Cognetti, MD0Jonathan D. Hughes, MD1Gregory R. Sprowls, MD2Christine M. McDonough, PhD3Soheil Sabzevari, MD4Aaron E. Barrow, MD5Albert Lin, MD6San Antonio Military Medical Center, San Antonio, TX, USA; Corresponding author: Daniel J. Cognetti, MD, Department of Orthopaedic Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.University of Pittsburgh Medical Center, Pittsburgh, PA, USABaylor Scott and White Medical Center, Temple, TX, USAUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USAUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USAUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USAUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USABackground: Proximal humerus fractures (PHFs) occur most commonly in an elderly and osteoporotic population, but a considerable proportion of these injuries occur in relatively younger individuals. Differences in treatment principles and outcomes in this younger population remain poorly understood. The purpose of this review was to characterize the treatment algorithms and outcomes for patients less than or equal to 60 years of age with PHFs. Methods: A comprehensive search of the Medline, Pubmed, Embase, and Cochrane databases for articles published between January 2005 and December 2020 was performed in January 2021. Levels of evidence I-IV analyzing outcomes (patient reported outcomes and/or complications) following PHFs in adult patients less than or equal to 60 years of age were included. The search was carried out in accordance with the preferred reported items for systematic reviews and meta-analyses guidelines. The risk of bias 2 tool and methodological index for nonrandomized studies score were utilized to evaluate included studies. Results: Fourteen studies met the inclusion criteria (open reduction internal fixation: 5, intramedullary nail: 4, hemiarthroplasty: 2, nonoperative: 1, and reverse total shoulder arthroplasty (RTSA): 1). Seven studies reported differences in outcomes between younger and older patient populations, with three studies noting separate management algorithms for those 60 years of age or younger. There were no studies comparing different treatments modalities in those less than 60 years of age, and the lone study on RTSA did not include patient-reported outcomes. Conclusion: Treatment algorithms and outcomes following PHFs in patients less than or equal to 60 years of age are distinctly different from that of a more elderly population. However, evidence-based treatment recommendations for this younger population are limited by the lack of studies comparing treatment modalities and the absence of patient-reported outcomes for individuals undergoing RTSA.http://www.sciencedirect.com/science/article/pii/S2666639123000111Proximal humerus fractureReverse total shoulder arthroplastyOpen reduction internal fixationHemiarthroplastyIntramedullary nailOutcomes |
| spellingShingle | Daniel J. Cognetti, MD Jonathan D. Hughes, MD Gregory R. Sprowls, MD Christine M. McDonough, PhD Soheil Sabzevari, MD Aaron E. Barrow, MD Albert Lin, MD Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review JSES Reviews, Reports, and Techniques Proximal humerus fracture Reverse total shoulder arthroplasty Open reduction internal fixation Hemiarthroplasty Intramedullary nail Outcomes |
| title | Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review |
| title_full | Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review |
| title_fullStr | Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review |
| title_full_unstemmed | Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review |
| title_short | Proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger: a systematic review |
| title_sort | proximal humerus fracture management and outcomes are distinctly different for individuals 60 years of age or younger a systematic review |
| topic | Proximal humerus fracture Reverse total shoulder arthroplasty Open reduction internal fixation Hemiarthroplasty Intramedullary nail Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666639123000111 |
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