Kerschbaum, Maximilian and Pangerl, Daniel and Henssler, Leopold and Akers, Michael and Zeman, Florian and Alt, Volker and Klute, Lisa (2025) Proposal for a new treatment algorithm for proximal humerus fractures based on a clinical survey among 340 surgeons. JOURNAL OF SHOULDER AND ELBOW SURGERY, 34 (6). e371-e379. ISSN 1058-2746, 1532-6500
Full text not available from this repository. (Request a copy)Abstract
Background: The increasing incidence of proximal humeral fractures poses complex challenges in determining the optimal therapeutic strategies due to the diverse fracture patterns and individual patient characteristics. Traumatologists and orthopedic surgeons face significant decisions, as potential consequences such as pain, functional limitations, and complications may significantly affect patients' quality of life. Given the varying viewpoints on appropriate treatment modalities, a thorough examination of current care practices is crucial. Methods: An adaptive online survey was conducted to present realistic case scenarios, aimed at elucidating decision-making processes in the management of proximal humeral fractures. This survey encompassed relevant patient and fracture-related variables, employing a dynamic querying algorithm that featured up to 48 conceivable case scenarios. Results: Analysis of 7012 case scenarios unveiled significant differences in treatment preferences across distinct patient age groups. Plate osteosynthesis emerged as the preferred modality for individuals below 50 years of age with complex fracture patterns. On the other hand, a balanced consideration between plate osteosynthesis and reverse shoulder arthroplasty was observed in the 50-70 age cohort. Notably, respondents favored reverse shoulder arthroplasty as the treatment modality of choice for individuals older than 70 years of age. A treatment algorithm was developed to outline decision pathways concisely, considering these patient age groups and the option of reverse shoulder Discussion and conclusion: This study provides clinically relevant insights into therapeutic decision-making processes in the management of proximal humeral fractures. The illustration of treatment preferences through a visualized algorithm serves as a crucial tool for evidencebased clinical decision-making, offering potential in enhancing the individualized care spectrum for patients with proximal humeral (c) 2024 The Author(s). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MANAGEMENT; SHOULDER; OUTCOMES; QUALITY; ADULTS; TRIAL; Proximal humeral fractures; humeral head fractures; shoulder; shoulder surgery; shoulder injuries; shoulder fractures |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie Medicine > Lehrstuhl für Strahlentherapie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 02 Jun 2026 08:50 |
| Last Modified: | 02 Jun 2026 08:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65907 |
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