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Evidence-based Decision-making in Geriatric Proximal Humerus Fractures
Patrick S Sullivan1, Christopher T Cosgrove1
1Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue #500, Memphis, TN 38104, USA.
The Orthopedic Clinics of North America
|November 16, 2025
Summary
Proximal humerus fractures in elderly patients often require surgery. Management of complex fractures is debated, with arthroplasty gaining traction but lacking clear indications. Patient factors are key to treatment decisions.
Area of Science:
- Orthopedic surgery
- Geriatric medicine
- Traumatology
Background:
- Proximal humerus fractures are prevalent in the elderly population.
- Management strategies for complex fractures are not standardized.
- Non-operative care and locked plating have been traditional treatments.
Purpose of the Study:
- To review current treatment options for proximal humerus fractures.
- To discuss the evolving role of arthroplasty in managing these fractures.
- To highlight the importance of patient-specific factors in treatment selection.
Main Methods:
- Literature review of treatment modalities for proximal humerus fractures.
- Analysis of indications and outcomes for non-operative management, locked plating, and arthroplasty.
- Discussion of factors influencing treatment decisions in complex cases.
Main Results:
- Non-operative management and locked plating remain common treatments.
- Shoulder arthroplasty is increasingly considered but requires well-defined indications.
- Pre-injury function, patient expectations, and bone quality are critical considerations.
Conclusions:
- Treatment decisions for proximal humerus fractures should be individualized.
- Further research is needed to clarify optimal indications for arthroplasty.
- A comprehensive assessment of patient factors is essential for successful outcomes.
