title: Hemiarthroplasty versus reverse shoulder arthroplasty for treatment of proximal humeral fractures: a meta-analysis.
abstract: BACKGROUND
  We performed a meta-analysis of studies with at least Level IV evidence to compare outcomes between hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures.
  
  
  METHODS
  Three electronic databases (PubMed, Cochrane, and EMBASE) were searched. The quality of each study was investigated, and data on radiographic and functional outcomes were extracted and analyzed.
  
  
  RESULTS
  The analysis included 1 Level I study, 1 Level II study, 3 Level III studies, and 2 Level IV studies. Reverse shoulder arthroplasty was more favorable than hemiarthroplasty in forward elevation (P < .001), abduction (P < .001), tuberosity healing (P = .002), Constant score (P < .001), American Shoulder and Elbow Surgeons score (P < .001), and Disabilities of the Arm, Shoulder and Hand score (P = .001). Only external rotation (P = .85) was not in favor of reverse shoulder arthroplasty.
  
  
  CONCLUSIONS
  The available literature suggests that reverse shoulder arthroplasty performed to address complex proximal humeral fractures might result in more favorable clinical outcomes than hemiarthroplasty performed for the same indication.
authors.affiliation: Leni & Peter May Department of Orthopaedics, Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: dshukla@gmail.com.
authors.forename: Dave R
authors.initials: DR
authors.lastname: Shukla
authors.affiliation: Leni & Peter May Department of Orthopaedics, Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: McAnany
authors.affiliation: Leni & Peter May Department of Orthopaedics, Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Leni & Peter May Department of Orthopaedics, Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Sam
authors.initials: S
authors.lastname: Overley
authors.affiliation: Leni & Peter May Department of Orthopaedics, Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Bradford O
authors.initials: BO
authors.lastname: Parsons
mesh_terms: D019643:Arthroplasty, Replacement / Q000379:methods*; D017102:Fracture Healing; D062785:Hemiarthroplasty; D006801:Humans; D016059:Range of Motion, Articular; D012399:Rotation; D012784:Shoulder Fractures / Q000601:surgery*; D012785:Shoulder Joint / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Reverse shoulder arthroplasty; hemiarthroplasty; meta-analysis; proximal humeral fracture