Acute surgical management of proximal humerus fractures: ORIF vs. hemiarthroplasty vs. reverse shoulder arthroplasty

How age and gender influence proximal humerus fracture management in patients older than fifty years

“…In a 2020 study, Yahuaca et al reported age to be associated with surgical treatment selection for proximal humerus fractures such that patients older than 65 years had significantly more arthroplasty procedures, whereas those aged 65 years and younger had significantly more ORIF procedures. 52 Although this particular finding differed from our study, the trend was similar such that as patients aged, the rate of RSA procedures increased, whereas the rate of ORIF procedures decreased for both genders.…”

Proximal humerus fractures: epidemiology and trends in surgical management of hospital-admitted patients in Portugal

“…These findings may represent a change in fracture pattern complexity, increased surgical differentiation, insights on the importance of accurate reduction of the greater tuberosity for shoulder function, and/or increased demand for better functionality among the elderly. 2 , 37 In the elderly, poorer bone quality often precludes osteosynthesis, which may be associated with unsatisfying functional outcomes. This partly explains the increased use of arthroplasty, particularly RSA.…”

“…6 , since 2011, there was a noteworthy decline in HA as opposed to RSA, potentially associated with unpredictable motion and unsatisfactory outcomes of HA. 9 , 11 , 13 , 16 , 18 , 28 , 37 Moreover, the ICD-9 code for RSA was only introduced in 2011. Before that time, RSAs were probably codified as TSA, as found in our validation sample.…”

Bilateral Reverse Total Shoulder Arthroplasty with Soft Tissue Release for Bilateral Posterior Fracture Dislocation after Status Epilepticus

“…A large literature review released in 2015 [13] and comparing 4500 patients showed that attributes slightly improved functional outcomes to patients treated with ORIF, though with significantly higher revision rates. Secondly, an article published in 2019 [14] dealing with 425 cases including three modalities (ORIF, reverse shoulder arthroplasty, and hemiarthroplasty) concludes that ORIF and reverse shoulder arthroplasty confer the same postoperative range of motion when used to treat proximal humerus fractures. However, patients treated with ORIF had a higher rate of reoperation when compared to the group treated via RSA.…”