RESEARCH ARTICLE


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
1 Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
2 Department of Surgery and Traumatology, Westfriesgasthuis, Maelsonstraat 3, 1624 NP Hoorn, The Netherlands


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Creative Commons License
© den Hartog et al.; LicenseeBentham Open.

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.

* Address correspondence to this author at the Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, ‘s Gravendijkwal 230, Office H-960, 3015 CE Rotterdam, The Netherlands; Tel: +31 10 7032395; Fax: +31 10 7032396; E-mail: d.denhartog@erasmusmc.nl


Abstract

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.

Keywords: Proximal humeral fractures, arthroplasty, shoulder fractures, review, therapy.