الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The main outcome measure was comparing between the uses of hemiarthroplasty versus open reduction internal fixation as the ideal treatment for three and four part fractures of the proximal humerus in elderly population which yielded that the functional outcome (CMS) for pain, activities of daily living, range of motion, and the subjective outcome (SSV) in the arthroplasty group was the same as the osteosynthesis group although in our believe the choice of the treatment modality was based on the assessment of perfusion of the humeral head so this led to lack of randomization which had negatively biased this study.
In Schliemann et al (48)
Regarding outcome and complications of open reduction internal fixation of three and four part fractures of the proximal humerus in the elderly population which yielded that the functional and patient-orientated results of the locking plate fixation of complex displaced proximal humerus fractures in the elderly has shown 29% of revision rate which in our believe is a catastrophic rate of complications making this study controversial to other studies and not either satisfying or comparable to those of primary arthroplasty and minimally invasive treatments.
Summary
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In Moonot et al (49)
Regarding Early results of ORIF of three and four part fractures of the proximal humerus which yielded that this study shows that the PHILOS plate can give good results in the treatment of displaced three and four-part fractures.
In Fattoretto et al (50)
Regarding outcome of open reduction internal fixation of three and four part fractures of the proximal humerus which yielded that PHILOS, associated with an adequate surgical technique and a good rehabilitation, can be considered an effective option in the treatment of displaced three and four part humeral fractures.
In Gaheer et al (51)
Regarding outcome of Fixation of 3- and 4-part Proximal Humerus Fractures Using the PHILOS Plate which yielded that this study suggests that treatment with the PHILOS plate gives a satisfactory outcome in patients with displaced 3- and 4-part fractures of the proximal humerus.
In Gavaskar et al (52)
Regarding outcome of applying Second generation locked plating for three and four part fractures of the proximal humerus in very elderly patients which yielded that this study
Summary
96
results include satisfactory results with second generation techniques in 3 and 4 part fractures in very elderly patients.
In Cai et al (53)
Regarding outcome of Internal Fixation Versus Shoulder Hemiarthroplasty for Displaced 4-part Proximal Humeral Fractures in Elderly Patients which yielded that the results of this study indicate an advantage in functional outcomes and quality of life favoring shoulder hemiarthroplasty when compared with ORIF in elderly patients with displaced 4-part fractures of the proximal humerus, The main advantage appeared to be in pain and DASH scores at 24 months.
In Solberg et al (54)
Regarding Surgical Treatment of Three and Four-Part Proximal Humeral Fractures which yielded that comparing similar groups of patients with a three or four-part proximal humeral fracture, the overall outcome after locked-plate fixation was better than that after hemiarthroplasty although in our believe this study limitations especially articular head splitting fractures and impaction which were treated with hemiarthroplasty and not ORIF had slightly biased the results.
In Hussain S, et al (55)
Regarding Open reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel
Summary
97
T-Plate which yielded that by using proximal humerus T- plate fixation for 2- part and 3-part fractures has shown good functional outcome for treating 2- part fractures but not satisfactory when treating 3-part fractures or 4 -part fractures due to severe comminution of the fracture, osteoporotic bone and unstable fixation.
In H. Lill, et al (56)
Regarding proximal humeral fractures: how stiff should an implant be? Comparing methods of fixation: using humerus T-plate (HTP), the cross screw Osteosynthesis (CSO), the unreamed proximal humerus nail with spiral blade (UHN), the recently developed Synclaw Proximal Humerus Nail (Synclaw PHN) and the angle-stable Locking Compression Plate Proximal Humerus (LCP-PH) which yielded that the LCP-PH, showed a low load decrease with a low load level and a steady curve, which is promising for long-term stability making it a good option for fixation.
In James et al (57)
Regarding Biomechanical Analysis of Plate Osteosynthesis Systems for Proximal Humerus Fractures using five types of plates which yielded that Construct A which was an AO, 4.5-mm, narrow, low contact dynamic compression (LCDC), eight-hole plate (Synthes, Paoli, PA) displayed the most favorable characteristics. In every situation, this truss-type
Summary
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construct scored the greatest relative stiffness value and reached statistical significance in five of the eight testing modes, the triangulation screw of construct A provides maximum rigidity for plate fixation of surgical neck humerus fractures making it a good option for fixation.