{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T01:22:30Z","timestamp":1780363350467,"version":"3.54.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Surgical treatment of complex humeral head fractures in the elderly is challenging due to osteoporotic bone, comorbidities and reduced compliance. The treatment strategy (reconstruction versus replacement) should allow for a functional aftercare and result in a high patient satisfaction. Major complications leading to surgical revision are crucial and should be avoided. The purpose of this study was to analyse the major complication rate leading to surgical revision and the patient-based outcome in complex humeral head fractures of the elderly population treated either using locking plate fixation (LCP) or reversed total shoulder arthroplasty (rTSA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and Methods<\/jats:title>\n                <jats:p>All patients older than 65\u00a0years surgically treated due to a four-part fracture of the proximal humerus between 2003 and 2015 were enrolled in our retrospective study. Major complications and revision rates were recorded and functional outcome was assessed using the Munich Shoulder Questionnaire (MSQ) allowing for qualitative self-assessment of the Shoulder Pain and Disability Index (SPADI), of the Disability of the Arm, Shoulder and Hand (DASH) score and of the Constant Score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A cohort of 103 patients with a mean age of 73.4\u2009\u00b1\u20096.2\u00a0years suffering from four-part fractures of the humeral head were enrolled. 63 patients were treated using the LCP fixation compared to 40 rTSAs. There were no significant differences in the patient-reported functional outcome. The revision rate was significantly higher in the LCP group (10\/63; 15.9%) compared to the rTSA group (1\/40; 2.5%). Reasons for revision were avascular head necrosis, cut-out of screws, secondary dislocation of the greater tuberosity and hypersensitivity to metal.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Reversed total shoulder arthroplasty and locking plate fixation are both established surgical procedures for the management of complex proximal humerus fractures in the elderly leading to similar functional results. However the revision rate in the rTSA group was significantly lower. Primary rTSA should, therefore, be favoured in multimorbid elderly patients with an increased complication risk to avoid repeated anaesthesia.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-021-04124-3","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T11:04:46Z","timestamp":1629889486000},"page":"3247-3254","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Reconstruction or replacement? A challenging question in surgical treatment of complex humeral head fractures in the elderly"],"prefix":"10.1007","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2764-4178","authenticated-orcid":false,"given":"M.","family":"M\u00fcller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Greve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Cr\u00f6nlein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Zyskowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Pesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Biberthaler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kirchhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Beirer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"issue":"4","key":"4124_CR1","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1080\/000164701753542023","volume":"72","author":"CM Court-Brown","year":"2001","unstructured":"Court-Brown CM, Garg A, McQueen MM (2001) The epidemiology of proximal humeral fractures. Acta Orthop Scand 72(4):365\u2013371. https:\/\/doi.org\/10.1080\/000164701753542023","journal-title":"Acta Orthop Scand"},{"key":"4124_CR2","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1097\/01.blo.0000194672.79634.78","volume":"442","author":"M Palvanen","year":"2006","unstructured":"Palvanen M, Kannus P, Niemi S, Parkkari J (2006) Update in the epidemiology of proximal humeral fractures. Clin Orthop Relat Res 442:87\u201392","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"4124_CR3","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1093\/gerona\/glt092","volume":"68","author":"KE Ensrud","year":"2013","unstructured":"Ensrud KE (2013) Epidemiology of fracture risk with advancing age. J Gerontol A Biol Sci Med Sci 68(10):1236\u20131242. https:\/\/doi.org\/10.1093\/gerona\/glt092","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"4","key":"4124_CR4","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1067\/mse.2002.124346","volume":"11","author":"CS Neer 2nd","year":"2002","unstructured":"Neer CS 2nd (2002) Four-segment classification of proximal humeral fractures: purpose and reliable use. J Shoulder Elbow Surg 11(4):389\u2013400. https:\/\/doi.org\/10.1067\/mse.2002.124346","journal-title":"J Shoulder Elbow Surg"},{"issue":"2","key":"4124_CR5","doi-asserted-by":"publisher","first-page":"121","DOI":"10.2106\/jbjs.i.01505","volume":"93","author":"JE Bell","year":"2011","unstructured":"Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, Tosteson AN (2011) Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. J Bone Joint Surg Am 93(2):121\u2013131. https:\/\/doi.org\/10.2106\/jbjs.i.01505","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"4124_CR6","doi-asserted-by":"publisher","first-page":"475","DOI":"10.3109\/17453674.2011.588856","volume":"82","author":"S Brorson","year":"2011","unstructured":"Brorson S, Frich LH, Winther A, Hrobjartsson A (2011) Locking plate osteosynthesis in displaced 4-part fractures of the proximal humerus. Acta Orthop 82(4):475\u2013481. https:\/\/doi.org\/10.3109\/17453674.2011.588856","journal-title":"Acta Orthop"},{"key":"4124_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2019.11.026","author":"JD Barlow","year":"2020","unstructured":"Barlow JD, Logli AL, Steinmann SP, Sems SA, Cross WW, Yuan BJ, Torchia ME, Sanchez-Sotelo J (2020) Locking plate fixation of proximal humerus fractures in patients older than 60 years continues to be associated with a high complication rate. J Shoulder Elbow Surg. https:\/\/doi.org\/10.1016\/j.jse.2019.11.026","journal-title":"J Shoulder Elbow Surg"},{"issue":"6","key":"4124_CR8","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1016\/j.jse.2009.06.004","volume":"18","author":"C Thanasas","year":"2009","unstructured":"Thanasas C, Kontakis G, Angoules A, Limb D, Giannoudis P (2009) Treatment of proximal humerus fractures with locking plates: a systematic review. J Shoulder Elbow Surg 18(6):837\u2013844. https:\/\/doi.org\/10.1016\/j.jse.2009.06.004","journal-title":"J Shoulder Elbow Surg"},{"issue":"2","key":"4124_CR9","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1213\/ane.0000000000003514","volume":"127","author":"LA Evered","year":"2018","unstructured":"Evered LA, Silbert BS (2018) Postoperative cognitive dysfunction and noncardiac surgery. Anesth Analg 127(2):496\u2013505. https:\/\/doi.org\/10.1213\/ane.0000000000003514","journal-title":"Anesth Analg"},{"issue":"3","key":"4124_CR10","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1097\/yco.0000000000000321","volume":"30","author":"L Evered","year":"2017","unstructured":"Evered L, Scott DA, Silbert B (2017) Cognitive decline associated with anesthesia and surgery in the elderly: does this contribute to dementia prevalence? Curr Opin Psychiatry 30(3):220\u2013226. https:\/\/doi.org\/10.1097\/yco.0000000000000321","journal-title":"Curr Opin Psychiatry"},{"issue":"4","key":"4124_CR11","first-page":"213","volume":"5","author":"A Seidl","year":"2017","unstructured":"Seidl A, Sholder D, Warrender W, Livesey M, Williams G, Abboud J, Namdari S (2017) Early versus late reverse shoulder arthroplasty for proximal humerus fractures: does it matter? Arch Bone Joint Surg 5(4):213\u2013220","journal-title":"Arch Bone Joint Surg"},{"issue":"8","key":"4124_CR12","doi-asserted-by":"publisher","first-page":"e236","DOI":"10.1097\/bot.0000000000000858","volume":"31","author":"E Sebastia-Forcada","year":"2017","unstructured":"Sebastia-Forcada E, Lizaur-Utrilla A, Cebrian-Gomez R, Miralles-Munoz FA, Lopez-Prats FA (2017) Outcomes of reverse total shoulder arthroplasty for proximal humeral fractures: primary arthroplasty versus secondary arthroplasty after failed proximal humeral locking plate fixation. J Orthop Trauma 31(8):e236\u2013e240. https:\/\/doi.org\/10.1097\/bot.0000000000000858","journal-title":"J Orthop Trauma"},{"issue":"6","key":"4124_CR13","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.2106\/00004623-197052060-00001","volume":"52","author":"CS Neer II","year":"1970","unstructured":"Neer CS II (1970) Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg Am 52(6):1077\u20131089","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"4124_CR14","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1754-9493-6-9","volume":"6","author":"F Schmidutz","year":"2012","unstructured":"Schmidutz F, Beirer M, Braunstein V, Bogner V, Wiedemann E, Biberthaler P (2012) The Munich Shoulder Questionnaire (MSQ): development and validation of an effective patient-reported tool for outcome measurement and patient safety in shoulder surgery. Patient Saf Surg 6(1):9. https:\/\/doi.org\/10.1186\/1754-9493-6-9","journal-title":"Patient Saf Surg"},{"key":"4124_CR15","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s40001-015-0178-5","volume":"20","author":"M Beirer","year":"2015","unstructured":"Beirer M, Cr\u00f6nlein M, Venjakob A, Saier T, Schmitt-Sody M, Huber-Wagner S, Biberthaler P, Kirchhoff C (2015) Additional calcar support using a blade device reduces secondary varus displacement following reconstruction of the proximal humerus: a prospective study. Eur J Med Res 20:82\u201382. https:\/\/doi.org\/10.1186\/s40001-015-0178-5","journal-title":"Eur J Med Res"},{"issue":"3","key":"4124_CR16","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1016\/j.injury.2019.02.003","volume":"50","author":"F Greve","year":"2019","unstructured":"Greve F, Beirer M, Zyskowski M, Cronlein M, Muller M, Pesch S, Felix S, Biberthaler P, Buchholz A, Kirchhoff C (2019) Prospective outcome analysis following tenodesis of the long head of the biceps tendon along with locking plate osteosynthesis for proximal humerus fractures. Injury 50(3):681\u2013685. https:\/\/doi.org\/10.1016\/j.injury.2019.02.003","journal-title":"Injury"},{"issue":"2","key":"4124_CR17","first-page":"255","volume":"51","author":"L Capuano","year":"2011","unstructured":"Capuano L, Poulain S, Hardy P, Longo UG, Denaro V, Maffulli N (2011) No correlation between physicians administered elbow rating systems and patient\u2019s satisfaction. J Sports Med Phys Fitness 51(2):255\u2013259","journal-title":"J Sports Med Phys Fitness"},{"issue":"2","key":"4124_CR18","doi-asserted-by":"publisher","first-page":"271","DOI":"10.11138\/mltj\/2017.7.2.271","volume":"7","author":"A Giardella","year":"2017","unstructured":"Giardella A, Ascione F, Mocchi M, Berlusconi M, Romano AM, Oliva F, Maradei L (2017) Reverse total shoulder versus angular stable plate treatment for proximal humeral fractures in over 65 years old patients. Muscles Ligaments Tendons J 7(2):271\u2013278. https:\/\/doi.org\/10.11138\/mltj\/2017.7.2.271","journal-title":"Muscles Ligaments Tendons J"},{"issue":"4","key":"4124_CR19","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1302\/0301-620X.89B4.18435","volume":"89","author":"T Bufquin","year":"2007","unstructured":"Bufquin T, Hersan A, Hubert L, Massin P (2007) Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly: a prospective review of 43 cases with a short-term follow-up. J Bone Joint Surg Br 89(4):516\u2013520. https:\/\/doi.org\/10.1302\/0301-620X.89B4.18435","journal-title":"J Bone Joint Surg Br"},{"issue":"4","key":"4124_CR20","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1302\/0301-620X.92B4.22450","volume":"92","author":"JF Cazeneuve","year":"2010","unstructured":"Cazeneuve JF, Cristofari DJ (2010) The reverse shoulder prosthesis in the treatment of fractures of the proximal humerus in the elderly. J Bone Joint Surg Br 92(4):535\u2013539. https:\/\/doi.org\/10.1302\/0301-620X.92B4.22450","journal-title":"J Bone Joint Surg Br"},{"issue":"5","key":"4124_CR21","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1007\/s00167-009-0744-x","volume":"17","author":"A Tavakkolizadeh","year":"2009","unstructured":"Tavakkolizadeh A, Ghassemi A, Colegate-Stone T, Latif A, Sinha J (2009) Gender-specific Constant score correction for age. Knee Surg Sports Traumatol Arthrosc 17(5):529\u2013533. https:\/\/doi.org\/10.1007\/s00167-009-0744-x","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"4","key":"4124_CR22","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/S1058274604000795","volume":"13","author":"R Hertel","year":"2004","unstructured":"Hertel R, Hempfing A, Stiehler M, Leunig M (2004) Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg 13(4):427\u2013433. https:\/\/doi.org\/10.1016\/S1058274604000795","journal-title":"J Shoulder Elbow Surg"},{"issue":"1","key":"4124_CR23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.jse.2007.03.026","volume":"17","author":"JD Bastian","year":"2008","unstructured":"Bastian JD, Hertel R (2008) Initial post-fracture humeral head ischemia does not predict development of necrosis. J Shoulder Elbow Surg 17(1):2\u20138. https:\/\/doi.org\/10.1016\/j.jse.2007.03.026","journal-title":"J Shoulder Elbow Surg"},{"issue":"Suppl 2","key":"4124_CR24","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/s0020-1383(16)47002-6","volume":"47","author":"C von Ruden","year":"2016","unstructured":"von Ruden C, Augat P (2016) Failure of fracture fixation in osteoporotic bone. Injury 47(Suppl 2):S3-s10. https:\/\/doi.org\/10.1016\/s0020-1383(16)47002-6","journal-title":"Injury"},{"issue":"Suppl 2","key":"4124_CR25","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.1007\/s00198-004-1728-9","volume":"16","author":"P Augat","year":"2005","unstructured":"Augat P, Simon U, Liedert A, Claes L (2005) Mechanics and mechano-biology of fracture healing in normal and osteoporotic bone. Osteoporos Int 16(Suppl 2):S36-43. https:\/\/doi.org\/10.1007\/s00198-004-1728-9","journal-title":"Osteoporos Int"},{"issue":"5","key":"4124_CR26","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1055\/s-0032-1315291","volume":"150","author":"O Ackermann","year":"2012","unstructured":"Ackermann O, Stanjek M, Rulander C, von Schulze PC (2012) Proximal cut-out of the hip screw: cement augmentation as a minimally invasive rescue procedure. Zeitschrift fur Orthopadie und Unfallchirurgie 150(5):484\u2013487. https:\/\/doi.org\/10.1055\/s-0032-1315291","journal-title":"Zeitschrift fur Orthopadie und Unfallchirurgie"},{"issue":"2","key":"4124_CR27","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s11678-018-0440-x","volume":"13","author":"JC Katthagen","year":"2018","unstructured":"Katthagen JC, Lutz O, Voigt C, Lill H, Ellwein A (2018) Cement augmentation of humeral head screws reduces early implant-related complications after locked plating of proximal humeral fractures. Obere Extrem 13(2):123\u2013129. https:\/\/doi.org\/10.1007\/s11678-018-0440-x","journal-title":"Obere Extrem"},{"issue":"Suppl 3","key":"4124_CR28","doi-asserted-by":"publisher","first-page":"44","DOI":"10.2106\/jbjs.g.00648","volume":"89","author":"SJ Nho","year":"2007","unstructured":"Nho SJ, Brophy RH, Barker JU, Cornell CN, MacGillivray JD (2007) Management of proximal humeral fractures based on current literature. J Bone Joint Surg Am 89(Suppl 3):44\u201358. https:\/\/doi.org\/10.2106\/jbjs.g.00648","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"4124_CR29","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1034\/j.1398-9995.2001.00086.x","volume":"56","author":"T Schafer","year":"2001","unstructured":"Schafer T, Bohler E, Ruhdorfer S, Weigl L, Wessner D, Filipiak B, Wichmann HE, Ring J (2001) Epidemiology of contact allergy in adults. Allergy 56(12):1192\u20131196. https:\/\/doi.org\/10.1034\/j.1398-9995.2001.00086.x","journal-title":"Allergy"},{"issue":"1","key":"4124_CR30","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jcot.2017.10.003","volume":"9","author":"S Akil","year":"2018","unstructured":"Akil S, Newman JM, Shah NV, Ahmed N, Deshmukh AJ, Maheshwari AV (2018) Metal hypersensitivity in total hip and knee arthroplasty: current concepts. J Clin Orthop Trauma 9(1):3\u20136. https:\/\/doi.org\/10.1016\/j.jcot.2017.10.003","journal-title":"J Clin Orthop Trauma"},{"issue":"10","key":"4124_CR31","doi-asserted-by":"publisher","first-page":"e295","DOI":"10.1016\/j.jse.2016.02.015","volume":"25","author":"F Haasters","year":"2016","unstructured":"Haasters F, Siebenburger G, Helfen T, Daferner M, Bocker W, Ockert B (2016) Complications of locked plating for proximal humeral fractures\u2014are we getting any better? J Shoulder Elbow Surg 25(10):e295-303. https:\/\/doi.org\/10.1016\/j.jse.2016.02.015","journal-title":"J Shoulder Elbow Surg"},{"issue":"1","key":"4124_CR32","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1186\/s12891-018-2150-3","volume":"19","author":"JNE Harjula","year":"2018","unstructured":"Harjula JNE, Paloneva J, Haapakoski J, Kukkonen J, \u00c4\u00e4rimaa V, Registry FSA, G (2018) Increasing incidence of primary shoulder arthroplasty in Finland\u2014a nationwide registry study. BMC Musculoskelet Disord 19(1):245\u2013245. https:\/\/doi.org\/10.1186\/s12891-018-2150-3","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"4124_CR33","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1097\/BOT.0000000000000229","volume":"29","author":"AK Gupta","year":"2015","unstructured":"Gupta AK, Harris JD, Erickson BJ, Abrams GD, Bruce B, McCormick F, Nicholson GP, Romeo AA (2015) Surgical management of complex proximal humerus fractures\u2014a systematic review of 92 studies including 4500 patients. J Orthop Trauma 29(1):54\u201359. https:\/\/doi.org\/10.1097\/BOT.0000000000000229","journal-title":"J Orthop Trauma"},{"issue":"4","key":"4124_CR34","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.jor.2019.03.007","volume":"16","author":"JHM van Ochten","year":"2019","unstructured":"van Ochten JHM, van der Pluijm M, Pouw M, Felsch QTM, Heesterbeek P, de Vos MJ (2019) Long-term survivorship and clinical and radiological follow-up of the primary uncemented Delta III reverse shoulder prosthesis. J Orthop 16(4):342\u2013346. https:\/\/doi.org\/10.1016\/j.jor.2019.03.007","journal-title":"J Orthop"},{"key":"4124_CR35","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.19.00595","author":"CM Robinson","year":"2019","unstructured":"Robinson CM, Stirling PHC, Goudie EB, MacDonald DJ, Strelzow JA (2019) Complications and long-term outcomes of open reduction and plate fixation of proximal humeral fractures. J Bone Joint Surg Am. https:\/\/doi.org\/10.2106\/jbjs.19.00595","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"4124_CR36","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1016\/j.jse.2019.02.015","volume":"28","author":"C Spross","year":"2019","unstructured":"Spross C, Meester J, Mazzucchelli RA, Puskas GJ, Zdravkovic V, Jost B (2019) Evidence-based algorithm to treat patients with proximal humerus fractures\u2014a prospective study with early clinical and overall performance results. J Shoulder Elbow Surg 28(6):1022\u20131032. https:\/\/doi.org\/10.1016\/j.jse.2019.02.015","journal-title":"J Shoulder Elbow Surg"}],"updated-by":[{"DOI":"10.1007\/s00402-021-04267-3","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000}}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-021-04124-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-021-04124-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-021-04124-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T16:11:33Z","timestamp":1664467893000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-021-04124-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,25]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["4124"],"URL":"https:\/\/doi.org\/10.1007\/s00402-021-04124-3","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s00402-021-04267-3","asserted-by":"object"}]},"ISSN":["1434-3916"],"issn-type":[{"value":"1434-3916","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,25]]},"assertion":[{"value":"5 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 November 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00402-021-04267-3","URL":"https:\/\/doi.org\/10.1007\/s00402-021-04267-3","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"CK is OR instructor for Arthrex. PB is OR instructor for DepuySynthes, Zimmer Biomet, Smith & Nephew, Arthrex, Medartis and Bonesupport. CK and PB declare that no conflicts of interest arise from these relations. All other authors declare that they have no competing interests. None of the authors have received financial payments from any commercial institution in relationship with the conduction of this study and the publication of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was registered and\u00a0approved by the local ethics committee (Ethics Committee of the medical faculty, Klinikum rechts der Isar, Technical University of Munich, Germany; study number 71\/15 S).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients included in this retrospective study were informed about the means of the study and signed an informed consent when returning the PROM questionnaire.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}