{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:40:13Z","timestamp":1767796813678,"version":"3.49.0"},"reference-count":31,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Exploratory Clinical Research Project of Shanghai Sixth People\u2019s Hospital","award":["ynts202402"],"award-info":[{"award-number":["ynts202402"]}]},{"name":"Shanghai Shenkang Hospital Development Center Municipal Hospital Diagnosis and Treatment Technology Promotion and Optimization Management Project","award":["SHDC12021117"],"award-info":[{"award-number":["SHDC12021117"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,14]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Proximal humeral fractures are increasingly common, particularly among older people, whereas the prognosis of surgical treatments for these fractures remains substantially uncertain. In China, where the ageing population is rapidly growing, high-quality prospective data on surgical outcomes, complications and cost-effectiveness are lacking. To address this gap, we propose to initiate a prospective, multicentre cohort study on surgical treatment for proximal humeral fractures in China\u2014Cohort of Acute Shoulder Trauma (CAST) study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The CAST is a multicentre, prospective cohort study enrolling patients with acute proximal humeral fractures undergoing surgical treatments at eight hospitals in China between May 2024 and December 2029. Patients can receive any of the surgical treatment methods which include percutaneous Kirschner wire fixation, external fixation, open reduction and internal fixation using locking plates or intramedullary nails, suture anchors and shoulder arthroplasty. We will collect patient-reported outcome measures (Quick Disabilities of the Arm, Shoulder and Hand), Constant-Murley, American Shoulder and Elbow Surgeons, EuroQol 5-Dimension and Visual Analogue Scale), physical examination results, imaging assessments (based on X-rays, ultrasound, CT and MRI scans), laboratory tests (including inflammatory cytokines) and data on medical costs. We will follow patients at 1\u2009day, and at 1 month, 3 months, 6 months, 12 months and 24 months postoperatively. The planned sample size is 1500 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol has been approved by the Ethics Committee of Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University (Approval No. 2024-ky-104(K)). Written informed consent will be obtained from all participants. Findings from the CAST study will be disseminated through peer-reviewed journals and academic conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study registration number<\/jats:title>\n                    <jats:p>ChiCTR2500109651.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105820","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:30:16Z","timestamp":1765175416000},"page":"e105820","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["What is the postoperative prognosis of proximal humeral fractures in China? Protocol for a multicentre prospective cohort study (CAST)"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-6380","authenticated-orcid":false,"given":"Qiuke","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated toShanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yijie","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated toShanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"National Center for Orthopaedics, Shanghai Sixth People's Hospital, Shanghai, 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