Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 18;9(8):e24.00356.
doi: 10.5435/JAAOSGlobal-D-24-00356. eCollection 2025 Aug 1.

Changing Demographic and Treatment Trends of Proximal Humerus Fractures: A TriNetX Analysis of 74,781 Patients

Gregory Connors  1 , Spencer Rasmussen, Yusuf Mahmoud, Alec Kellish, Asif M Ilyas
Affiliations

Changing Demographic and Treatment Trends of Proximal Humerus Fractures: A TriNetX Analysis of 74,781 Patients

Gregory Connors et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Introduction: As the US population continues to age and diversify, so have treatment strategies for proximal humerus fractures (PHFs). The primary hypothesis of this study is that PHFs are increasing in prevalence with an associated increase in the rate of its surgical management.

Methods: The TriNetX US Collaborative Network database was queried for all patients diagnosed with PHFs between 2016 and 2022. Current Procedural Terminology codes were used to group patients into cohorts based on surgical versus nonsurgical treatment. Incidence and treatment rate differences were analyzed between demographic groups such as age, sex, and ethnicity.

Results: A total of 74,781 PHFs were identified and analyzed between 2016 and 2022. The average overall PHF surgical incidence rate between 2016 and 2022 was 10.5%. Open reduction and internal fixation (ORIF) was the most common surgical treatment (68.5%). Overall utilization of total shoulder arthroplasty (TSA/rTSA) surgical techniques increased from 2016 to 2022 for all fracture types (P < 0.0001), while ORIF (P = 0.0079) and hemiarthroplasty (P = 0.0432) utilization decreased. Women were less likely to undergo surgical treatment than men (odds ratio [OR], 0.9490; P < 0.05). White patients were more likely to receive surgical treatment than Black (OR, 0.7688; P < 0.0001) and Asian patients (OR, 0.7770; P = 0.0043).

Conclusion: Surgical management strategies have changed with TSA/rTSA becoming more frequently used for all fracture types with a decline in the utilization of ORIF and hemiarthroplasty. This study suggests a shift in surgical treatment strategies between 2016 and 2022, and reflects increased utilization of arthroplasty procedures for fracture management.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Graph of incidence proportions of proximal humerus fractures.
Figure 2
Figure 2
Graph showing the treatment strategy trends 2016 to 2022. ORIF = open reduction and internal fixation, rTSA = reverse total shoulder arthroplasty, TSA = total shoulder arthroplasty
See this image and copyright information in PMC

References

    1. Pencle F, Varacallo M: Proximal Humerus Fracture. StatPearls. StatPearls Publishing, 2024. http://www.ncbi.nlm.nih.gov/books/NBK470346/. Accessed June 22, 2024. - PubMed
    1. Rudran B, Little C, Duff A, Poon H, Tang Q: Proximal humerus fractures: Anatomy, diagnosis and management. Br J Hosp Med 2022;83:1-10. - PubMed
    1. Bruinsma WE, Goslings JC, Schep NWL, Ring D: Nonoperatively treated proximal humerus fractures: Randomized trial of immediate versus delayed initiation of exercises. Arch Bone Joint Surg 2023;11:672-676. - PMC - PubMed
    1. Iyengar JJ, Devcic Z, Sproul RC, Feeley BT: Nonoperative treatment of proximal humerus fractures: A systematic review. J Orthop Trauma 2011;25:612-617. - PubMed
    1. Misra S, Vaishya R, Trikha V, Maheshwari J: Practice guidelines for proximal humeral fractures. J Clin Orthop Trauma 2019;10:631-633. - PMC - PubMed

MeSH terms

LinkOut - more resources