{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:00Z","timestamp":1789020420068,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anterior shoulder dislocation combined with humeral surgical neck fracture is a severe injury that often requires emergency surgery. However, for some patients, such as those of advanced age or with surgical contraindications, closed reduction can be considered. This retrospective cohort study aimed to confirm the feasibility and clinical outcomes of the closed reduction technique with effective external fixation for the treatment of anterior shoulder dislocation combined with humeral surgical neck fracture in elderly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>From January 2010 to March 2024, a total of 51 patients with anterior shoulder dislocation combined with humeral surgical neck fracture from Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine participated in this study. All patients underwent emergency closed reduction and external fixation. Whether they would be finally included in the statistical analysis was determined based on the post-reduction imaging results. We conducted follow-up for more than one year on the patients who were finally included in the study. We also recorded patients' general characteristics, fracture-dislocation classification (type I, type II, type III), fracture reduction and healing status, as well as the affected limb's function scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      After screening, 38 patients were included in the cohort, and ultimately 34 patients completed the follow-up. Among them, there were 11 males and 23 females. Their ages ranged from 65 to 90 years, with an average of (74.15\u2009\u00b1\u20097.36) years. All 34 patients comprised 15 cases of type I, 14 cases of type II, and 5 cases of type III, respectively. Notably, 64.71% (22\/34) of them achieved successful closed reduction, including 13 cases of type I, 9 cases of type II, and no case of type III. At the last follow-up, 8.82% (3\/34) and 5.88% (2\/34) of patients experienced humeral head ischemic necrosis and nonunion of fractures, respectively. The Constant Murley shoulder function score for conservative treatment patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921) ranged from 68 to 95 points, with an average of (83.90\u2009\u00b1\u20096.62) points.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emergency closed reduction is feasible for anterior shoulder dislocation combined with humeral surgical neck fracture. Therefore, closed reduction and external fixation should be considered as an optional approach, mainly applicable to elderly patients with reducible Type I or Type II fracture-dislocation classification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1853922","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:32:03Z","timestamp":1789018323000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of closed reduction and external fixation in elderly patients with anterior shoulder dislocation combined with humeral surgical neck fracture: a retrospective cohort study based on fracture-dislocation classification"],"prefix":"10.3389","volume":"13","author":[{"given":"Feng","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Huaian Hospital of Huaian City","place":["Huaian, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songyi","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Jinshazhou Hospital Affiliated to Guangzhou University of Chinese Medicine","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taotao","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Wujiang District Pingwang Community Health Service Center","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueqiang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e80713","DOI":"10.7759\/cureus.80713","article-title":"A literature review on whether immobilization of the shoulder in external rotation improves healing and prevents the recurrence of acute shoulder dislocations","volume":"17","author":"Kazim","year":"2025","journal-title":"Cureus"},{"key":"B2","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s12245-025-00866-8","article-title":"An original closed reduction technique for acute shoulder dislocation: the wrist-clamping and shoulder-lifting","volume":"18","author":"Dai","year":"2025","journal-title":"Int J Emerg Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"103323","DOI":"10.1016\/j.amsu.2022.103323","article-title":"Fracture of the humeral surgical neck and shoulder dislocation following an epileptic seizure: case report","volume":"74","author":"Alibrahim","year":"2022","journal-title":"Ann Med Surg (Lond)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1816","DOI":"10.3390\/medicina60111816","article-title":"The impact of the position of the humeral head relative to the glenoid on iatrogenic fractures during shoulder dislocation reduction","volume":"60","author":"Gunsoy","year":"2024","journal-title":"Medicina (Kaunas)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1067\/mse.2002.124346","article-title":"Four-segment classification of proximal humeral fractures: purpose and reliable use","volume":"11","author":"Neer","year":"2002","journal-title":"J Shoulder Elbow Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"26","DOI":"10.13107\/jocr.2019.v10.i01.1624","article-title":"Comminuted bilateral simultaneous fracture and luxation of the proximal humerus with an injury to the right axillary artery","volume":"10","author":"Irimia","year":"2019","journal-title":"J Orthop Case Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.ajem.2024.09.060","article-title":"An umbrella review of systematic reviews and meta-analyses for assessment and treatment of acute shoulder dislocation","volume":"87","author":"Gonai","year":"2025","journal-title":"Am J Emerg Med"},{"key":"B8","first-page":"674","article-title":"Advances in the treatment of shoulder anterior dislocation associated with proximal humerus fracture","volume":"9","author":"Zhao","year":"2020","journal-title":"Chin J Bone Joint"},{"key":"B9","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3969\/j.issn.1003-0034.2018.02.016","article-title":"Treatment of proximal humerus fractures combined with shoulder dislocation using bone setting manipulation","volume":"31","author":"Jiang","year":"2018","journal-title":"Chin J Orthop Traumatol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e480","DOI":"10.1016\/j.jse.2022.04.018","article-title":"Fracture dislocations of the proximal humerus treated with open reduction and internal fixation: a systematic review","volume":"31","author":"Miltenberg","year":"2022","journal-title":"J Shoulder Elbow Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"S1058","DOI":"10.1016\/j.jse.2026.02.027","article-title":"Social determinants of health and outcomes in proximal humerus fractures based on surgery type","volume":"35","author":"Zhu","year":"2026","journal-title":"J Shoulder Elbow Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s10195-026-00914-w","article-title":"ORIF Of three- and four-part proximal humeral fractures: a retrospective study of long-term clinical and complication outcomes of two-plate fixation methods","volume":"27","author":"Conteduca","year":"2026","journal-title":"J Orthop Traumatol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1016\/j.jos.2025.03.011","article-title":"Constant-Murley score categorization to assess outcomes after reverse shoulder arthroplasty following complex proximal humeral fracture","volume":"30","author":"Miralles-Mu\u00f1oz","year":"2025","journal-title":"J Orthop Sci"},{"key":"B14","doi-asserted-by":"publisher","first-page":"19","DOI":"10.31053\/1853.0605.v76.n1.21630","article-title":"Quantitative assessment of the loss of functionality associated with the appearance of complications in osteosynthesis of proximal humerus fractures","volume":"76","author":"Hern\u00e1ndez Fern\u00e1ndez","year":"2019","journal-title":"Rev Fac Cien Med Univ Nac Cordoba"},{"key":"B15","doi-asserted-by":"publisher","first-page":"615","DOI":"10.5435\/JAAOS-20-10-615","article-title":"Shoulder dislocation in the older patient","volume":"20","author":"Murthi","year":"2012","journal-title":"J Am Acad Orthop Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1227.e1","DOI":"10.1016\/j.jhsa.2021.09.009","article-title":"Patterns of nerve injury and recovery rates of infraclavicular brachial plexus lesions following anterior shoulder dislocation","volume":"47","author":"Wu","year":"2022","journal-title":"J Hand Surg Am"},{"key":"B17","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1016\/j.jse.2021.09.003","article-title":"Proximal humeral fracture-dislocations: which patterns can be reduced in the emergency department?","volume":"31","author":"Green","year":"2022","journal-title":"J Shoulder Elbow Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1186\/1756-0500-7-770","article-title":"Successful closed reduction for iatrogenic displacement of the anatomical neck of the humerus: a case report","volume":"7","author":"Koda","year":"2014","journal-title":"BMC Res Notes"},{"key":"B19","doi-asserted-by":"publisher","first-page":"110469","DOI":"10.1016\/j.ijscr.2024.110469","article-title":"Traumatic anterior fracture dislocation of the humeral head. A rare case report","volume":"124","author":"Kondo","year":"2024","journal-title":"Int J Surg Case Rep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2331","DOI":"10.1016\/j.jse.2021.01.025","article-title":"Outcomes of open reduction and internal fixation of proximal humerus fracture dislocations","volume":"30","author":"Padegimas","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12968\/hmed.2021.0554","article-title":"Proximal humerus fractures: anatomy, diagnosis and management","volume":"83","author":"Rudran","year":"2022","journal-title":"Br J Hosp Med (Lond)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1977","DOI":"10.1016\/j.jse.2024.12.005","article-title":"Consensus statement on the treatment of proximal humerus fractures: a Delphi approach by the neer circle of the American shoulder and elbow surgeons","volume":"34","author":"Williams","year":"2025","journal-title":"J Shoulder Elbow Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1007\/s00264-025-06425-3","article-title":"Comparison of locking plate and conservative treatment in elderly patients with displaced proximal humerus fractures","volume":"49","author":"Bezirgan","year":"2025","journal-title":"Int Orthop"},{"key":"B24","doi-asserted-by":"publisher","first-page":"112024","DOI":"10.1016\/j.injury.2024.112024","article-title":"Factors associated with failure of locking plate fixation in proximal humerus fractures","volume":"56","author":"Cosic","year":"2025","journal-title":"Injury"},{"key":"B25","doi-asserted-by":"publisher","first-page":"284","DOI":"10.17392\/1033-19","article-title":"A new plate design to treat displaced 3\u20134 parts proximal humeral fractures in comparison to the most tested and used plate: clinical and radiographic study","volume":"16","author":"Rollo","year":"2019","journal-title":"Med Glas (Zenica)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"298","DOI":"10.11138\/ccmbm\/2017.14.3.298","article-title":"Grafting and fixation of proximal humeral aseptic non union: a prospective case series","volume":"14","author":"Rollo","year":"2017","journal-title":"Clin Cases Miner Bone Metab"},{"key":"B27","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.joad.2015.12.003","article-title":"Displaced 3- and 4-part proximal humeral fractures: evaluation and management with an intramedullary nail within 48\u2005h, in the emergency department","volume":"5","author":"Nobile","year":"2016","journal-title":"J Acute Dis"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1853922\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:32:05Z","timestamp":1789018325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1853922\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2026.1853922"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1853922","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"1853922"}}