Summary
Results from three randomized controlled trials (one of these is included with the caveat that it is an e-publication accessed ahead of the published version) were consistent with respect to treatment of three and four part fractures of the proximal humerus. All studies found no significant difference in functional outcomes; however, complications were significantly higher in the osteosynthesis treatment arm compared with the conservative arm in the two recent reports. Small sample size and subsequent lack of power to detect a difference between treatments was problematic in all studies. Larger, randomized studies are needed to further elucidate whether there is a difference between treatments in terms of functional outcome.
