{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:23:34Z","timestamp":1787657014865,"version":"build-2736575974"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006692","name":"Universit\u00e0 degli Studi di Torino","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006692","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Orthop Surg Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Proximal humerus fractures (PHFs) are common in the elderly population, but the optimal treatment strategy remains controversial. This study evaluated the long-term functional outcomes of non-surgically treated PHFs and assessed whether retrospective treatment recommendations made by experienced shoulder surgeons were associated with differences in clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 150 PHFs in 149 patients treated nonoperatively between 2020 and 2021. Two-, three-, and four-part fractures with a minimum 12-month follow-up were analyzed. Outcome measures included QuickDASH, Oxford Shoulder Score (OSS), Subjective Shoulder Value (SSV), and SF-12. Demographic characteristics and radiographic fracture features were analyzed. In a second phase, five shoulder surgeons independently reviewed anonymized cases and retrospectively recommended surgical or conservative treatment while blinded to patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At a mean follow-up of 32.1 months, younger age, absence of comorbidities, better pre-injury physical status, and dominant limb involvement were independently associated with superior outcomes, whereas the number of fracture fragments did not. Displaced fractures showed worse outcomes than non-displaced fractures. However, among displaced fractures, no significant differences in SSV, OSS, QuickDASH, or SF-12 scores were found between fractures retrospectively considered surgical candidates and those deemed suitable for conservative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Functional recovery following conservative treatment of PHFs appears to be influenced more by patient-related factors than by fracture morphology or surgeon experience. These findings suggest that carefully selected patients with displaced PHFs can achieve satisfactory outcomes with nonoperative treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Levels of evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-026-04920-w","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:08:07Z","timestamp":1787656087000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of patient-related factors and surgeon experience on functional outcomes in conservatively treated proximal humerus fractures: a retrospective cohort study"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0239-2576","authenticated-orcid":false,"given":"Andrea","family":"Pautasso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3487-6242","authenticated-orcid":false,"given":"Chiara","family":"Bernardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Assom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2823-7697","authenticated-orcid":false,"given":"Davide","family":"Blonna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5172-299X","authenticated-orcid":false,"given":"Federica","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0439-7848","authenticated-orcid":false,"given":"Raffaele","family":"Garofalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-3306","authenticated-orcid":false,"given":"Alessandro","family":"Marinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4303-5102","authenticated-orcid":false,"given":"Paolo","family":"Paladini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7669-0798","authenticated-orcid":false,"given":"Filippo","family":"Castoldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6638-501X","authenticated-orcid":false,"given":"Enrico","family":"Bellato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SICSeG (Italian Society of Shoulder and Elbow Surgery) Research Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"4920_CR1","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1302\/0301-620X.96B7.32894","volume":"96","author":"ND Clement","year":"2014","unstructured":"Clement ND, Duckworth AD, McQueen MM, Court-Brown CM (2014) The outcome of proximal humeral fractures in the elderly: predictors of mortality and function. 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