title: Reverse total shoulder arthroplasty for the treatment of proximal humeral fractures: patterns of use among newly trained orthopedic surgeons.
abstract: BACKGROUND
  This study compared the use of reverse and hemishoulder arthroplasty for the treatment of proximal humeral fractures among orthopedic surgeons taking part II of the American Board of Orthopaedic Surgery board examination. We hypothesized that the use of reverse shoulder arthroplasty for fractures in the elderly is increasing amongst newly trained orthopedic surgeons.
  
  
  METHODS
  We queried the American Board of Orthopaedic Surgery database for the cases of proximal humeral fractures treated with arthroplasty submitted between 2005 and 2012. We evaluated the prosthesis used, patient-specific factors, complications, and the difference in use by shoulder fellowship-trained surgeons.
  
  
  RESULTS
  From 2005 to 2012, 5395 board-eligible orthopedic surgeons submitted cases to the database. Of these, 435 (mean, 54 per year) were proximal humeral fractures treated with arthroplasty. The overall incidence of reverse shoulder arthroplasty for fracture increased from 2% to 4% during 2005 to 2007 to 38% in 2012. Shoulder surgeons treated 5 times more proximal humeral fractures with shoulder arthroplasty and were also more than 20 times more likely to use a reverse implant (P < .0001). The difference in complication rates between reverse and hemishoulder arthroplasty was not significant (P = .49). Patients who received a hemiarthroplasty tended to be younger (mean age, 70.8 vs 75.7 years; P = .0015).
  
  
  CONCLUSIONS
  Overall, the use of a hemiarthroplasty for fracture is still more common (62% in 2012), although the relative proportion of reverse implants is rising. Among shoulder surgeons, more than 50% of the arthroplasties performed for fractures during the past 3 years (2010-2012) have been reverse arthroplasties.
authors.affiliation: Kaiser Permanente, Panorama City, CA, USA. Electronic address: acevedomd@gmail.com.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Acevedo
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Tobias
authors.initials: T
authors.lastname: Mann
authors.affiliation: The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Abboud
authors.affiliation: The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Getz
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Judith F
authors.initials: JF
authors.lastname: Baumhauer
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
authors.forename: Ilya
authors.initials: I
authors.lastname: Voloshin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012784:Shoulder Fractures / Q000453:epidemiology / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D014481:United States / Q000453:epidemiology
keywords: Reverse shoulder arthroplasty; proximal humeral fracture; shoulder trauma