. 2015 May 10:16:112.

doi: 10.1186/s12891-015-0564-8.

A scoping review of the proximal humerus fracture literature

Gerard P Slobogean^{1

2

3}, Herman Johal⁴, Kelly A Lefaivre⁵, Norma J MacIntyre⁶, Sheila Sprague^{7

8}, Taryn Scott⁹, Pierre Guy¹⁰, Peter A Cripton^{11

12}, Michael McKee¹³, Mohit Bhandari^{14

15}

Affiliations

¹ Division of Orthopaedic Surgery, Department of Surgery, Master University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. gslobogean@umoa.umm.edu.
² Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. gslobogean@umoa.umm.edu.
³ Division of Orthopaedic Trauma, Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland, 22 S. Greene Street, Baltimore, MD, USA. gslobogean@umoa.umm.edu.
⁴ Division of Orthopaedic Trauma, Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland, 22 S. Greene Street, Baltimore, MD, USA. hermanjohal@gmail.com.
⁵ Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. kelly.lefaivre@vch.ca.
⁶ School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada. macint@mcmaster.ca.
⁷ Division of Orthopaedic Surgery, Department of Surgery, Master University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. sprags@mcmaster.ca.
⁸ Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. sprags@mcmaster.ca.
⁹ Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. scottta@mcmaster.ca.
¹⁰ Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. pierre.guy@ubc.ca.
¹¹ Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. cripton@mech.ubc.ca.
¹² Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC, Canada. cripton@mech.ubc.ca.
¹³ Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, Canada. mckeem@smh.ca.
¹⁴ Division of Orthopaedic Surgery, Department of Surgery, Master University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. bhandam@mcmaster.ca.
¹⁵ Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. bhandam@mcmaster.ca.

PMID: 25958203
PMCID: PMC4464621
DOI: 10.1186/s12891-015-0564-8

A scoping review of the proximal humerus fracture literature

Gerard P Slobogean et al. BMC Musculoskelet Disord. 2015.

. 2015 May 10:16:112.

doi: 10.1186/s12891-015-0564-8.

Authors

Affiliations

¹ Division of Orthopaedic Surgery, Department of Surgery, Master University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. gslobogean@umoa.umm.edu.
² Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. gslobogean@umoa.umm.edu.
³ Division of Orthopaedic Trauma, Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland, 22 S. Greene Street, Baltimore, MD, USA. gslobogean@umoa.umm.edu.
⁴ Division of Orthopaedic Trauma, Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland, 22 S. Greene Street, Baltimore, MD, USA. hermanjohal@gmail.com.
⁵ Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. kelly.lefaivre@vch.ca.
⁶ School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada. macint@mcmaster.ca.
⁷ Division of Orthopaedic Surgery, Department of Surgery, Master University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. sprags@mcmaster.ca.
⁸ Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. sprags@mcmaster.ca.
⁹ Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. scottta@mcmaster.ca.
¹⁰ Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. pierre.guy@ubc.ca.
¹¹ Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, Canada. cripton@mech.ubc.ca.
¹² Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC, Canada. cripton@mech.ubc.ca.
¹³ Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, 149 College Street, Toronto, ON, Canada. mckeem@smh.ca.
¹⁴ Division of Orthopaedic Surgery, Department of Surgery, Master University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. bhandam@mcmaster.ca.
¹⁵ Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada. bhandam@mcmaster.ca.

PMID: 25958203
PMCID: PMC4464621
DOI: 10.1186/s12891-015-0564-8

Abstract

Background: Proximal humerus fractures are a common fragility fracture that significantly affects the independence of older adults. The outcomes of these fractures are frequently disappointing and previous systematic reviews are unable to guide clinical practice. Through an integrated knowledge user collaboration, we sought to map the breadth of literature available to guide the management of proximal humerus fractures.

Methods: We utilized a scoping review technique because of its novel ability to map research activity and identify knowledge gaps in fields with diverse treatments. Through multiple electronic database searches, we identified a comprehensive body of proximal humerus fracture literature that was classified into eight research themes. Meta-data from each study were abstracted and descriptive statistics were used to summarize the results.

Results: 1,051 studies met our inclusion criteria with the majority of research being performed in Europe (64%). The included literature consists primarily of surgical treatment studies (67%) and biomechanical fracture models (10%). Nearly half of all clinical studies are uncontrolled case series of a single treatment (48%). Non-randomized comparative studies represented 12% of the literature and only 3% of the studies were randomized controlled trials. Finally, studies with a primary outcome examining the effectiveness of non-operative treatment or using a prognostic study design were also uncommon (4% and 6%, respectively).

Conclusions: The current study provides a comprehensive summary of the existing proximal humerus fracture literature using a thematic framework developed by a multi-disciplinary collaboration. Several knowledge gaps have been identified and have generated a roadmap for future research priorities.

PubMed Disclaimer

Figures

**Figure 2**
Literature search and screening flow chart.

**Figure 4**
Cumulative number of publications by five year Increments and theme.

**Figure 5**
Proportion of proximal humerus fracture literature by theme.

See this image and copyright information in PMC

References

1. Osteoporosis Canada. Facts and Statistics. Available at: http://www.osteoporosis.ca/osteoporosis-and-you/osteoporosis-facts-and-s.... Accessed March 27, 2012.
1. Tarride JE, Hopkins RB, Leslie WD, Morin S, Adachi JD, Papaioannou A, et al. The burden of illness of osteoporosis in Canada. Osteoporos Int. 2012;23:2591–600. doi: 10.1007/s00198-012-1931-z. - DOI - PMC - PubMed
1. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand. 2001;72:365–71. doi: 10.1080/000164701753542023. - DOI - PubMed
1. Hajcsar EE, Hawker G, Bogoch ER. Investigation and treatment of osteoporosis in patients with fragility fractures. CMAJ. 2000;163:819–22. - PMC - PubMed
1. Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States nationwide emergency department sample, 2008. Arthritis Care Res. 2012;64:407–14. doi: 10.1002/acr.21563. - DOI - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

A scoping review of the proximal humerus fracture literature

Affiliations

A scoping review of the proximal humerus fracture literature

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous