Summary
Results from three recent studies were inconsistent with respect to treatment of three-
and four-part fractures of the proximal humerus. The one randomized controlled trial
found no difference in overall functional or clinical outcome between conservative
and surgical treatment. Small sample sizes and subsequent lack of power to detect
a difference between treatments was problematic in all studies. Selection bias was
present in both cohort studies. Larger, randomized studies are needed to further elucidate
whether there is a difference between treatments in terms of functional outcome.
Strength of evidence | Average methods score (out of 10)
