{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T03:13:13Z","timestamp":1767237193675,"version":"3.40.3"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11S","funder":[{"DOI":"10.13039\/100001473","name":"AO North America","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001473","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>To compare reoperation rates of acute versus delayed reverse total shoulder arthroplasty (RTSA) following a period of nonoperative treatment for proximal humerus fractures (PHFs). We also aimed to identify an optimal time interval from PHF to RTSA before the risk of reoperation significantly increased.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\u2009<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Database review.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Ontario, Canada.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patient Selection Criteria:<\/jats:title>\n            <jats:p>Adults aged 50 years and older who sustained a PHF (OTA\/AO 11A-C) between 2004 and 2019 were included. Exclusion criteria included polytrauma, open fractures, non-Ontario residents, invalid health insurance, and any operative treatment before RTSA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n            <jats:p>The primary outcome measure was reoperation within 2 years following RTSA. A risk-adjusted, restricted cubic spline was used to model the probability of reoperation according to the time elapsed between PHF and RTSA to identify a time point at which the risk of reoperation significantly increased. A multivariate logistics regression was used to identify predictors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>In total, 891 patients (685 acute, 206 delayed) underwent RTSA for PHF. The acute cohort had a significantly lower reoperation rate (3.9%) compared with the delayed cohort (8.3%) (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02). The odds of reoperation increased with a delay to RTSA greater than 28 days and continued to rise until 100 days after fracture. Patients who underwent RTSA 28 days after PHF were found to have a significantly higher odds of reoperation by 2 years (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Among patients undergoing RTSA for acute PHFs, a delay to surgery greater than 28 days is associated with a greater odds of reoperation and may be useful when counseling patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002884","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T13:02:29Z","timestamp":1729515749000},"page":"S2-S7","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Reverse Total Shoulder Arthroplasty for Acute Proximal Humerus Fractures: Is Delay Associated With an Increased Rate of Reoperation?"],"prefix":"10.1097","volume":"38","author":[{"given":"Jimmy","family":"Tat","sequence":"first","affiliation":[{"name":"Sunnybrook Orthopaedic Upper Limb (SOUL), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4845-7096","authenticated-orcid":false,"given":"Diane","family":"Nam","sequence":"additional","affiliation":[{"name":"Sunnybrook Orthopaedic Upper Limb (SOUL), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9636-8915","authenticated-orcid":false,"given":"Deva","family":"Thiruchelvam","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Michael","family":"Paterson","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-6031","authenticated-orcid":false,"given":"Ujash","family":"Sheth","sequence":"additional","affiliation":[{"name":"Sunnybrook Orthopaedic Upper Limb (SOUL), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250326","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1080\/000164701753542023","article-title":"The epidemiology of proximal humeral fractures","volume":"72","author":"Court-Brown","year":"2001","journal-title":"Acta Orthop Scand."},{"key":"R2-20250326","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.jse.2015.07.015","article-title":"Proximal humerus fragility fractures: recent trends in nonoperative and operative treatment in the Medicare population","volume":"25","author":"Han","year":"2016","journal-title":"J Shoulder Elbow Surg."},{"key":"R3-20250326","doi-asserted-by":"crossref","first-page":"e641","DOI":"10.3928\/01477447-20170411-03","article-title":"Trends in surgical management and costs for operative treatment of proximal humerus fractures in the elderly","volume":"40","author":"Hasty","year":"2017","journal-title":"Orthopedics."},{"key":"R4-20250326","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1001\/jama.2015.1629","article-title":"Surgical vs. nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial","volume":"313","author":"Rangan","year":"2015","journal-title":"JAMA."},{"key":"R5-20250326","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jse.2010.12.018","article-title":"Internal fixation versus nonoperative treatment of displaced 3-part proximal humeral fractures in elderly patients: a randomized controlled trial","volume":"20","author":"Olerud","year":"2011","journal-title":"J Shoulder Elbow Surg."},{"key":"R6-20250326","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/BOT.0b013e31821c2e15","article-title":"Surgical treatment with an angular stable plate for complex displaced proximal humeral fractures in elderly patients: a randomized controlled trial","volume":"26","author":"Fjalestad","year":"2012","journal-title":"J Orthop Trauma."},{"key":"R7-20250326","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1097\/BOT.0b013e3182008df8","article-title":"Nonoperative treatment of proximal humerus fractures: a systematic review","volume":"25","author":"Iyengar","year":"2011","journal-title":"J Orthop Trauma."},{"key":"R8-20250326","doi-asserted-by":"crossref","first-page":"e75464","DOI":"10.1371\/journal.pone.0075464","article-title":"Internal fixation versus nonoperative treatment for displaced 3-part or 4-part proximal humeral fractures in elderly patients: a meta-analysis of randomized controlled trials","volume":"8","author":"Li","year":"2013","journal-title":"PLoS One."},{"key":"R9-20250326","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1754-9493-7-34","article-title":"Complication rates and outcomes stratified by treatment modalities in proximal humeral fractures: a systematic literature review from 1970\u20132009","volume":"7","author":"Tepass","year":"2013","journal-title":"Patient Saf Surg."},{"key":"R10-20250326","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.jse.2009.06.004","article-title":"Treatment of proximal humerus fractures with locking plates: a systematic review","volume":"18","author":"Thanasas","year":"2009","journal-title":"J Shoulder Elbow Surg."},{"key":"R11-20250326","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jse.2009.03.024","article-title":"Functional outcomes after nonoperative management of fractures of the proximal humerus","volume":"18","author":"Hanson","year":"2009","journal-title":"J Shoulder Elbow Surg."},{"key":"R12-20250326","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/j.jse.2014.01.005","article-title":"Reverse total shoulder arthroplasty for the treatment of proximal humeral fractures: patterns of use among newly trained orthopedic surgeons","volume":"23","author":"Acevedo","year":"2014","journal-title":"J Shoulder Elbow Surg."},{"key":"R13-20250326","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00264-015-2670-5","article-title":"Reverse shoulder arthroplasty in acute fractures provides better results than in revision procedures for fracture sequelae","volume":"39","author":"Cicak","year":"2015","journal-title":"Int Orthop."},{"key":"R14-20250326","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1302\/0301-620X.101B10.BJJ-2019-0142.R2","article-title":"A higher reoperation rate following arthroplasty for failed fixation versus primary arthroplasty for the treatment of proximal humeral fractures: a retrospective population-based study","volume":"101B","author":"Nowak","year":"2019","journal-title":"Bone Joint J."},{"key":"R15-20250326","doi-asserted-by":"crossref","first-page":"2471549220949731","DOI":"10.1177\/2471549220949731","article-title":"Primary versus salvage reverse total shoulder arthroplasty for displaced proximal humerus fractures in the elderly: a systematic review and meta-analysis","volume":"4","author":"Nelson","year":"2020","journal-title":"J Shoulder Elb Arthroplast."},{"key":"R17-20250326","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1001\/jama.2017.17606","article-title":"Association between wait time and 30-day mortality in adults undergoing hip fracture surgery","volume":"318","author":"Pincus","year":"2017","journal-title":"JAMA."},{"key":"R18-20250326","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.jse.2015.12.002","article-title":"Outcomes of reverse total shoulder arthroplasty as primary versus revision procedure for proximal humerus fractures","volume":"25","author":"Dezfuli","year":"2016","journal-title":"J Shoulder Elbow Surg."},{"key":"R19-20250326","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/j.jse.2016.10.013","article-title":"Nonoperative management versus reverse shoulder arthroplasty for treatment of 3- and 4-part proximal humeral fractures in older adults","volume":"26","author":"Roberson","year":"2017","journal-title":"J Shoulder Elbow Surg."},{"key":"R20-20250326","doi-asserted-by":"crossref","first-page":"e143","DOI":"10.1016\/j.jse.2016.12.003","article-title":"Early vs. late reverse shoulder arthroplasty for proximal humerus fractures: does it matter?","volume":"26","author":"Seidl","year":"2017","journal-title":"J Shoulder Elbow Surg."},{"key":"R21-20250326","first-page":"832","article-title":"Acute versus delayed reverse shoulder arthroplasty for the primary treatment of proximal humeral fractures","volume":"29","author":"Seidel","year":"2021","journal-title":"J Am Acad Orthop Surg."},{"key":"R22-20250326","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1053\/j.sart.2020.05.007","article-title":"Acute versus delayed reverse total shoulder arthroplasty for proximal humerus fractures in the elderly: mid-term outcomes","volume":"30","author":"Kuhlmann","year":"2020","journal-title":"Semin Arthroplasty JSES."},{"key":"R23-20250326","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jse.2021.07.003","article-title":"Acute versus delayed reverse total shoulder arthroplasty for proximal humeral fractures: a consecutive cohort study","volume":"31","author":"Panagopoulos","year":"2022","journal-title":"J Shoulder Elbow Surg."},{"key":"R24-20250326","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1016\/j.injury.2021.05.040","article-title":"Acute versus delayed reverse total shoulder arthroplasty for the management of proximal humerus fractures","volume":"52","author":"Barger","year":"2021","journal-title":"Injury."},{"key":"R25-20250326","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.2106\/JBJS.RVW.21.00245","article-title":"Operative treatment of proximal humeral fractures with reverse total shoulder arthroplasty in patients \u226565 years old: a critical analysis review","volume":"10","author":"Lin","year":"2022","journal-title":"JBJS Rev."},{"key":"R26-20250326","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1302\/0301-620X.89B4.18435","article-title":"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","volume":"89","author":"Bufquin","year":"2007","journal-title":"J Bone Joint Surg Br."},{"key":"R27-20250326","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.jse.2018.10.004","article-title":"Acute versus delayed reverse total shoulder arthroplasty for the treatment of proximal humeral fractures in the elderly population: a systematic review and meta-analysis","volume":"28","author":"Torchia","year":"2019","journal-title":"J Shoulder Elbow Surg."},{"key":"R28-20250326","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/BOT.0000000000000229","article-title":"Surgical management of complex proximal humerus fractures-a systematic review of 92 studies including 4500 patients","volume":"29","author":"Gupta","year":"2015","journal-title":"J Orthop Trauma."},{"key":"R29-20250326","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s12178-020-09597-0","article-title":"Reverse shoulder arthroplasty for proximal humerus fracture","volume":"13","author":"Kelly","year":"2020","journal-title":"Curr Rev Musculoskelet Med."},{"key":"R30-20250326","doi-asserted-by":"crossref","first-page":"2677","DOI":"10.3390\/jcm11102677","article-title":"Survivorship of reverse shoulder arthroplasty according to indication, age and gender","volume":"11","author":"Chelli","year":"2022","journal-title":"J Clin Med."},{"key":"R31-20250326","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1080\/17453670902805098","article-title":"Risk factors for revision after shoulder arthroplasty: 1,825 shoulder arthroplasties from the Norwegian Arthroplasty Register","volume":"80","author":"Fevang","year":"2009","journal-title":"Acta Orthop."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T21:33:13Z","timestamp":1743283993000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":30,"journal-issue":{"issue":"11S","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000002884","relation":{},"ISSN":["0890-5339","1531-2291"],"issn-type":[{"type":"print","value":"0890-5339"},{"type":"electronic","value":"1531-2291"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-07-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}