title: [Treatment of proximal humeral fractures in Germany: Influence of the level of hospital care and the frequency of treatment].
abstract: BACKGROUND
  Various treatment options exist for displaced proximal humeral fractures. The impact of the level of hospital care and frequency of treatment on current treatment regimens in Germany was analyzed.
  
  
  METHODS
  A total of 576 hospitals were included. The survey covered questions on frequency, diagnostics, classification, therapy, complications, and clinical scenarios.
  
  
  RESULTS
  In all, 48% of the hospitals returned the questionnaire: 73% treat more than 60% of the fractures surgically, mainly with angle-stable implants. The angle-stable plate is the treatment of choice for young patients, but older patients are treated using other treatment options. Problems and complications included malreduction, secondary displacement, screw perforation, avascular necrosis, and impingement. According to treatment indication, implant choice, and common complications, no significant differences between the level of hospital care and frequency of treatment were observed.
  
  
  CONCLUSIONS
  Independent of the level of hospital care and frequency of treatment, there is a trend for head-preserving angular-stable surgery with a homogenous level of treatment in Germany.
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie, BG-Unfallklinik Tübingen, Eberhard-Karls-Universität Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Tepass
authors.forename: K
authors.initials: K
authors.lastname: Weise
authors.forename: B
authors.initials: B
authors.lastname: Rolauffs
authors.forename: G
authors.initials: G
authors.lastname: Blumenstock
authors.forename: C
authors.initials: C
authors.lastname: Bahrs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012784:Shoulder Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D055815:Young Adult