Trend shift in proximal humeral fracture treatment: a detailed review of national shoulder arthroplasty data

Abstract

Background/aim: This study is aimed to scrutinize the nationwide utilization trends of shoulder arthroplasty for proximal humerus fractures (PHFs), using a comprehensive national surgical database.Materials and methods: A retrospective study was conducted with 4181 patients who underwent shoulder arthroplasty due to PHF between 2016 and 2022 using national health records. They are grouped as hemiarthroplasty (HA), anatomical total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). The patients’ demographic data, hospitalization period, revision history, transfusion rates, mortality data, distribution of trends in arthroplasty methods by years, distribution of cases according to hospital characteristics, and geographical regions , were analyzed.Results: 22.1% of patients were treated with HA, 30.2% with TSA, and 47.7% with RSA. Lowest revision rate was after HA (4.3%), while high rates were seen after TSA (7.9%) and RSA (7.4%) (p=0.019). It was observed that there was a significant increasing trend in RSA rates and a decrease in HA and TSA rates over time (p