{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:08:26Z","timestamp":1790176106251,"version":"4.1.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Proximal humerus fractures (PHFs) are common injuries in adults and occur particularly often in older patients. In our hospital, patients are routinely scheduled for follow-up radiographs at approximately two and six to eight weeks after injury, although the management yield of this practice is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study of consecutive adults (\u2265\u200918 years) presenting with PHFs to the OLVG emergency department (ED) between January and April 2022. Patients with multiple fractures, pathological fractures, fractures initially treated or followed up at another hospital, and fractures other than proximal humerus fractures were excluded. The primary outcome was a documented treatment-plan change during the observed outpatient treatment period, including conversion from conservative to operative treatment, cancellation of planned surgery, or additional surgery after initial operative treatment. The primary outcome proportion was reported with a two-sided exact 95% confidence interval. Descriptive variables included fracture classification, comminution, imaging use, follow-up timing, secondary displacement, and treatment duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred patients were included (mean age 60.4\u2009\u00b1\u200918.0 years; 60% female). Most fractures were one-part (63%) or two-part (33%), 45% showed comminution, and 87% of patients were treated conservatively. The observed treatment-plan change rate was 0\/100 (0%; exact 95% confidence interval, 0.0\u20133.6%). Among the 87 patients initially treated conservatively, none converted to operative treatment. Secondary displacement occurred in nine patients, including one radiographic non-union and one malunion, but no treatment-plan change was documented in these patients. No revision surgery was performed. Patients underwent a mean of 3.0 radiographs, including the initial ED radiograph.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, routine follow-up radiographs had a low observed management yield: none was associated with a documented treatment-plan change. Because the upper 95% confidence limit was 3.6% and management reflected practice within a single hospital organisation, these data do not establish the safety of omitting radiographs. They support larger multicentre evaluation of clinically triggered rather than universally scheduled follow-up imaging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-026-03333-y","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:36:08Z","timestamp":1790174168000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The limited value of routine radiographs in the follow-up treatment of proximal humerus fractures"],"prefix":"10.1007","volume":"52","author":[{"given":"A. A.","family":"Elwakel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J. A.","family":"Willinge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Goslings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. A.","family":"Twigt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"9","key":"3333_CR1","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.3109\/17453674.2014.999299","volume":"39","author":"AP Launonen","year":"2015","unstructured":"Launonen AP, Lepola V, Flinkkil\u00e4 T, Laitinen M, Paavola M, Malmivaara A. Epidemiology and treatment trends of proximal humeral fractures in Finland. Int Orthop. 2015;39(9):1727\u201332. https:\/\/doi.org\/10.3109\/17453674.2014.999299.","journal-title":"Int Orthop"},{"issue":"40","key":"3333_CR2","doi-asserted-by":"publisher","first-page":"665","DOI":"10.3238\/arztebl.m2021.0238","volume":"118","author":"M Rupp","year":"2021","unstructured":"Rupp M, Walter N, Pfeifer C, Lang S, Kerschbaum M, Krutsch W, et al. The incidence of fractures among the adult population of Germany\u2014an analysis from 2009 through 2019. Dtsch Arztebl Int. 2021;118(40):665\u20139. https:\/\/doi.org\/10.3238\/arztebl.m2021.0238.","journal-title":"Dtsch Arztebl Int"},{"issue":"3","key":"3333_CR3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1002\/acr.21563","volume":"64","author":"SH Kim","year":"2012","unstructured":"Kim SH, Szabo RM, Marder RA. Epidemiology of humerus fractures in the United States: nationwide emergency department sample, 2008. Arthritis Care Res (Hoboken). 2012;64(3):407\u201314. https:\/\/doi.org\/10.1002\/acr.21563.","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"10","key":"3333_CR4","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1302\/2046-3758.510.2000638","volume":"5","author":"S Sabharwal","year":"2016","unstructured":"Sabharwal S, Patel NK, Griffiths D, Athanasiou T, Gupte CM, Reilly P. Trials based on specific fracture configuration and surgical procedures likely to be more relevant for decision making in the management of fractures of the proximal humerus: findings of a meta-analysis. Bone Joint Res. 2016;5(10):470\u201380. https:\/\/doi.org\/10.1302\/2046-3758.510.2000638.","journal-title":"Bone Joint Res"},{"issue":"1","key":"3333_CR5","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1186\/s13018-021-02551-x","volume":"16","author":"S Iglesias-Rodr\u00edguez","year":"2021","unstructured":"Iglesias-Rodr\u00edguez S, Dom\u00ednguez-Prado DM, Garc\u00eda-Reza A, Fern\u00e1ndez-Fern\u00e1ndez D, P\u00e9rez-Alfonso E, Garc\u00eda-Pi\u00f1eiro J, et al. Epidemiology of proximal humerus fractures. J Orthop Surg Res. 2021;16(1):402. https:\/\/doi.org\/10.1186\/s13018-021-02551-x.","journal-title":"J Orthop Surg Res"},{"key":"3333_CR6","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s11657-015-0209-4","volume":"10","author":"AP Launonen","year":"2015","unstructured":"Launonen AP, Lepola V, Saranko A, Flinkkil\u00e4 T, Laitinen M, Mattila VM. Epidemiology of proximal humerus fractures. Arch Osteoporos. 2015;10:209. https:\/\/doi.org\/10.1007\/s11657-015-0209-4.","journal-title":"Arch Osteoporos"},{"issue":"2","key":"3333_CR7","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1016\/j.jse.2023.07.038","volume":"33","author":"AG Papalia","year":"2024","unstructured":"Papalia AG, Romeo PV, Kingery MT, Alben MG, Lin CC, Simcox TG, et al. Trends in the treatment of proximal humerus fractures from 2010 to 2020. J Shoulder Elb Surg. 2024;33(2):e49\u201357. https:\/\/doi.org\/10.1016\/j.jse.2023.07.038.","journal-title":"J Shoulder Elb Surg"},{"key":"3333_CR8","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/s12178-022-09817-9","volume":"16","author":"N Martinez-Catalan","year":"2023","unstructured":"Martinez-Catalan N. Conservative treatment of proximal humerus fractures: when, how, and what to expect. Curr Rev Musculoskelet Med. 2023;16:75\u201384. https:\/\/doi.org\/10.1007\/s12178-022-09817-9.","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"4","key":"3333_CR9","doi-asserted-by":"publisher","first-page":"e244","DOI":"10.3928\/01477447-20230125-08","volume":"46","author":"DF Barreto Rocha","year":"2023","unstructured":"Barreto Rocha DF, Vogel M, Delma SR, Baylor JL, Horwitz DS, Grandizio LC. The utility of routine follow-up radiographs in the nonoperative management of proximal humerus fractures in patients 65 years and older. Orthopedics. 2023;46(4):e244\u20138. https:\/\/doi.org\/10.3928\/01477447-20230125-08.","journal-title":"Orthopedics"},{"key":"3333_CR10","doi-asserted-by":"crossref","unstructured":"Neer CS II. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am. 1970;52(6):1077\u201389.","DOI":"10.2106\/00004623-197052060-00001"},{"key":"3333_CR11","unstructured":"Gezondheidsraad. Richtlijnen goede voeding 2015. Den Haag: Gezondheidsraad; 2015. Available from: https:\/\/www.gezondheidsraad.nl\/documenten\/adviezen\/2015\/11\/04\/richtlijnen-goede-voeding-2015."},{"issue":"10","key":"3333_CR12","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1302\/0301-620X.101B10.BJJ-2019-0349.R1","volume":"101\u2013B","author":"M Jacxsens","year":"2019","unstructured":"Jacxsens M, Schmid J, Zdravkovic V, Jost B, Spross C. Is serial radiological evaluation of one-part proximal humeral fractures necessary? Bone Joint J. 2019;101\u2013B(10):1307\u201312. https:\/\/doi.org\/10.1302\/0301-620X.101B10.BJJ-2019-0349.R1.","journal-title":"Bone Joint J"},{"issue":"3","key":"3333_CR13","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jseint.2022.02.006","volume":"6","author":"M Chelli","year":"2022","unstructured":"Chelli M, Gasbarro G, Lavou\u00e9 V, Gauci MO, Raynier JL, Trojani C, et al. The reliability of the Neer classification for proximal humerus fractures: a survey of orthopedic shoulder surgeons. JSES Int. 2022;6(3):331\u20137. https:\/\/doi.org\/10.1016\/j.jseint.2022.02.006.","journal-title":"JSES Int"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-026-03333-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-026-03333-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-026-03333-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:36:09Z","timestamp":1790174169000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-026-03333-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3333"],"URL":"https:\/\/doi.org\/10.1007\/s00068-026-03333-y","relation":{},"ISSN":["1863-9941"],"issn-type":[{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"assertion":[{"value":"1 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Approval for this study was obtained from the Advisory Committee on Scientific Research (ACWO) of OLVG Hospital. The study was conducted in accordance with the principles of the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for individual informed consent was waived by the Advisory Committee on Scientific Research (ACWO) of OLVG Hospital because of the retrospective design of the study and the use of routinely collected clinical data.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"297"}}