Summary
Results from three randomized controlled trials (one of these is included with the
caveat that it is an e-publication accessed ahead of the published version) were consistent
with respect to treatment of three and four part fractures of the proximal humerus.
All studies found no significant difference in functional outcomes; however, complications
were significantly higher in the osteosynthesis treatment arm compared with the conservative
arm in the two recent reports. Small sample size and subsequent lack of power to detect
a difference between treatments was problematic in all studies. Larger, randomized
studies are needed to further elucidate whether there is a difference between treatments
in terms of functional outcome.
