Related Experiment Video
Updated: Aug 14, 2026
Development of a Novel Internal Fixation Model for Rat Radial Fractures: Fracture Healing Assessment and Dorsal Root Ganglion Isolation
Published on: March 13, 2026
Treatment patterns and outcomes in proximal humerus fracture management: a claims-based retrospective analysis of
Michael Beltran1, Jenny Pahys2, Jill Ruppenkamp3,4
1Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH, USA.
Background:
We evaluated factors associated with open reduction internal fixation (ORIF) and arthroplasty after proximal humerus fractures (PHF) and 12-month reoperation.
Methods:
A retrospective cohort was created using US healthcare claims from 2016-2025. Multinomial regression assessed factors associated with treatment. Multivariable Cox proportional hazards models evaluated 12-month reoperation risk.
Results:
Among 250,695 PHF patients, 86% were managed nonoperatively, 11% received ORIF, and 4% received arthroplasty. Among surgically treated patients, arthroplasty utilization increased modestly (24% to 29%), while ORIF declined (76% to 71%). Younger patients and males were more likely to undergo ORIF. Reoperation rates were 7.9% for ORIF and 7.8% for arthroplasty. In patients <54 years, ORIF had lower reoperation rates than arthroplasty (males: 6.84% vs. 13.36%, p = 0.002; females: 6.62% vs.18.24%, p < 0.001); in females aged 65-75, arthroplasty had lower reoperation rates than ORIF (5.39% vs. 7.87%, p < 0.001). Soft tissue (23.3%), mechanical (17.6%), and nonunion (14.1%) complications were observed among ORIF reoperations, versus soft tissue (9.8%) and infection (8.8%) in arthroplasty reoperations.
Conclusion:
ORIF remains the most common surgery for PHFs, while arthroplasty use increased. Reoperation rates were lower in younger ORIF patients but higher in older females. These findings may inform decision-making for operative treatment for PHFs.
