Primary Shoulder Arthroplasty Versus Conservative Treatment for Comminuted Proximal Humeral Fractures: A Systematic Literature Review
Dennis den Hartog*, 1, Jeroen de Haan2, Niels W. Schep1, Wim E. Tuinebreijer1
Identifiers and Pagination:Year: 2010
First Page: 87
Last Page: 92
Publisher ID: TOORTHJ-4-87
Article History:Received Date: 19/10/2009
Revision Received Date: 19/11/2009
Acceptance Date: 15/12/2009
Electronic publication date: 17/2/2010
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
The objective was to identify whether arthroplasty or conservative treatment is the best available treatment for three- and four-part proximal humeral fractures by analyzing the outcome measure of the Constant score. We conducted an electronic search. The systematic review included 33 studies encompassing 1096 patients with three- or four-part proximal humeral fractures that used the Constant score as outcome measure. The mean Constant score in the conservative group was 66.5 and in the arthroplasty group was 55.5. The difference could be attributed to selection bias, unreliable classification of the fractures and inter-observer differences in the assessment of the Constant score.