The online version of this article (doi:10.1186/s12891-015-0564-8) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
GPS conceived the project and participated in its design, the interpretation and analysis of data, and manuscript review and critical appraisal and revision. HJ participated in the acquisition and interpretation of data and participated manuscript review and critical appraisal and revision. KAL participated in acquisition and interpretation of data and participated in manuscript review and critical appraisal and revision. NJM participated in the interpretation of data with regard to clinical relevance in physiotherapy and in manuscript review and critical appraisal and revision. SS participated in project design and coordination and helped to draft the manuscript. TS participated in the gathering and analysis of data and helped to draft the manuscript. PG participated in the interpretation of the data with regard to clinical relevance in orthopaedic surgery. PAC participated in the interpretation of the data with regard to relevance in biomechanics. MM participated in the interpretation of the data with regard to clinical relevance in orthopaedic surgery. MB participated in project design and participated in manuscript review and critical appraisal and revision. All authors read and approved the final manuscript.
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.
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.
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).
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.
Additional file 1: Listing of included studies.12891_2015_564_MOESM1_ESM.docx
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- A scoping review of the proximal humerus fracture literature
Gerard P Slobogean
Kelly A Lefaivre
Norma J MacIntyre
Peter A Cripton
- BioMed Central
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