JSES reviews, reports, and techniques最新文献

{"title":"Preoperative humeral computed tomography may be a useful indicator of low bone mineral density in patients undergoing rotator cuff repair","authors":"Yuki Matsui MD, PhD ,&nbsp;Yusuke Menjo MD ,&nbsp;Yoshihiro Hojo MD, PhD ,&nbsp;Daisuke Momma MD, PhD ,&nbsp;Norimasa Iwasaki MD, PhD","doi":"10.1016/j.xrrt.2025.100624","DOIUrl":"10.1016/j.xrrt.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>Bone fragility can compromise rotator cuff repair, particularly in patients with osteoporosis. Although previous studies have demonstrated correlations between systemic bone mineral density (BMD) and bone quality, only a few have focused on the anchor-relevant regions in patients with rotator cuff tears. We hypothesized that preoperative computed tomography (CT)-based Hounsfield unit (HU) values at anchor-relevant areas in the proximal humerus could be used to estimate systemic BMD in these patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 58 patients (62 shoulders) who underwent arthroscopic rotator cuff repair and had both preoperative shoulder CT and dual energy X-ray absorptiometry scans. HU values were measured in 4 regions of interest within the proximal humerus: medial, central, lateral, and greater tuberosity (GT). Systemic BMD was assessed using femoral neck and lumbar spine T-scores and BMD values. Pearson correlation coefficients were used to evaluate the association between the HU values and systemic T-score/BMD. Multivariate linear regression analyses were performed using HU values at the GT after adjusting for age, sex, and rotator cuff tear size.</div></div><div><h3>Results</h3><div>HU values were significantly lower in the lateral and GT regions than in the medial and central regions (<em>P</em> &lt; .01). Among regions, the HU values at the GT showed the highest correlations with the systemic T-scores and BMD (all moderate): femoral neck T-score (r = 0.57), lumbar spine T-score (r = 0.55), femoral neck BMD (r = 0.60), and lumbar spine BMD (r = 0.56) (all <em>P</em> &lt; .01). Multivariate regression confirmed that GT values were independently associated with both femoral and lumbar T-score/BMD (adjusted R² = 0.37-0.45, <em>P</em> &lt; .001), even after controlling age, sex, and tear size.</div></div><div><h3>Conclusion</h3><div>Preoperative CT-derived HU values, particularly at the GT, have a moderate correlation with systemic T-scores and BMD in patients with rotator cuff tears. Given the lower HU values observed at the anchor insertion sites (GT and lateral regions), clinicians should consider the risk of bone fragility during surgical planning.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100624"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of locking humeral stems in reverse total shoulder arthroplasty for complex proximal humerus fractures: a scoping review","authors":"Victor Cardona-Perez BS ,&nbsp;Elyette Lugo BS ,&nbsp;Alberto R. Rivera MD ,&nbsp;Umasuthan Srikumaran MD, MBA, MPH","doi":"10.1016/j.xrrt.2025.100625","DOIUrl":"10.1016/j.xrrt.2025.100625","url":null,"abstract":"<div><div>The use of locked humeral stems in reverse total shoulder arthroplasty (rTSA) has emerged as an alternative fixation strategy for treating complex proximal humerus fractures (PHFs). This scoping review synthesizes the available literature evaluating clinical outcomes, radiographic findings, and complications associated with interlocking humeral stems in rTSA for PHFs. Nine studies, encompassing 434 patients, were identified, of whom 308 underwent rTSA with a locking humeral stem. The mean patient age was 75.7 ± 5.1 years, with a mean follow-up of 20.0 ± 8.9 months, and at least 54% of patients were female. Postoperative functional outcomes demonstrated a mean forward flexion of 120° ± 13.2°, abduction of 101° ± 2.3°, external rotation of 29.3° ± 8.9°, and internal rotation to the lumbar spine. Patient-reported outcomes showed a mean Quick Disabilities of the Arm, Shoulder, and Hand score of 31.4 ± 4.2 and a Constant-Murley Score of 65.4 ± 10.7. Tuberosity healing was observed in 76% of cases. The overall complication rate was 13.0%, with locking screw -related complications occurring in 1.6% of cases, accounting for 12.5% of all reported complications. These findings suggest that locked humeral stems provide reliable diaphyseal fixation with a low incidence of screw-related complications in rTSA for complex PHFs. Long-term success depends on achieving stable metaphyseal fixation and osteointegration; cemented or press-fit stems without screws remain viable alternatives. Further prospective, comparative studies are needed to clarify long-term outcomes and optimize implant selection.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100625"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative nonsteroidal anti-inflammatory drug prophylaxis for elbow heterotopic ossification: a systematic review and meta-analysis comparing COX-2 selective and nonselective inhibitors","authors":"Areeb Ahmad BS ,&nbsp;Roya Khorram MD ,&nbsp;Kassem Ghayyad MD ,&nbsp;Vraj Amin BS ,&nbsp;Amir R. Kachooei MD, PhD ,&nbsp;G. Russell Huffman MD, MPH ,&nbsp;Daryl C. Osbahr MD ,&nbsp;Luke S. Oh MD, MS","doi":"10.1016/j.xrrt.2025.100628","DOIUrl":"10.1016/j.xrrt.2025.100628","url":null,"abstract":"<div><h3>Background</h3><div>Heterotopic ossification (HO) is a significant complication following elbow trauma and surgery, leading to pain, stiffness, and functional impairment. While nonsteroidal anti-inflammatory drugs (NSAIDs) have been extensively investigated for HO prophylaxis, their effectiveness in preventing postoperative HO in the elbow remains unclear. This study aims to compare the efficacy of selective vs. nonselective NSAIDs in reducing postoperative HO rates after traumatic elbow surgeries.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was performed in PubMed, Embase, Cochrane Library, and Web of Science from January 2004 to January 10, 2025. Level I-III studies were included if they examined patients who underwent elbow surgery following trauma and compared selective COX-2 inhibitors or nonselective NSAIDs to no prophylaxis, with reported postoperative HO formation rates.</div></div><div><h3>Results</h3><div>A total of 2,429 articles were identified across the four databases. Following full-text review, 1 randomized control trial and 5 retrospective studies were included in the quantitative synthesis, comprising patients who underwent either acute post-traumatic surgery or postexcision/open arthrolysis for established HO. Both selective (celecoxib) and nonselective (indomethacin) NSAIDs demonstrated no statistically significant difference in reducing postoperative HO compared with controls (celecoxib: risk ratio = 0.64, 95% confidence interval 0.32-1.31, <em>P</em> = .22; indomethacin: risk ratio = 0.87, 95% confidence interval 0.65-1.18, <em>P</em> = .38). Nonselective (indomethacin and ibuprofen) and selective (celecoxib) NSAID prophylaxis significantly reduced HO incidence compared to controls (<em>P</em> = .007), demonstrating a 27% relative risk reduction.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that both selective (celecoxib) and nonselective (indomethacin and ibuprofen) NSAIDs effectively reduce the risk of HO following elbow trauma surgery. When analyzed individually, neither the selective COX-2 inhibitor (celecoxib) nor the nonselective NSAIDs (indomethacin, ibuprofen) showed a statistically significant difference compared with controls, indicating no clear difference in efficacy between NSAID classes. However, given the limited number of studies and interstudy heterogeneity, the overall power of the current evidence is low, and further prospective research is needed to validate these findings.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100628"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of endoscopic, thoracic segment long thoracic nerve decompression","authors":"Ryan Lohre MD,&nbsp;Sarah Koljaka BA,&nbsp;Nicholas Wiley MS,&nbsp;Joseph Macksood MS,&nbsp;Olive Kozelian BA,&nbsp;Bassem Elhassan MD","doi":"10.1016/j.xrrt.2025.100629","DOIUrl":"10.1016/j.xrrt.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>Axillary and inferior periscapular pain often presents with scapulothoracic abnormal motion and observable winging and can be debilitating for patients. Our hypothesis is that endoscopic long thoracic nerve (LTN) decompression in the thoracic segment is effective at improving axillary and inferior periscapular border pain.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed of all patients diagnosed with persistent axillary and inferior periscapular border pain receiving endoscopic LTN decompression at a single institution, performed by 2 surgeons between 2020 and 2024. Patient demographics and patient pre- and postoperative patient-reported outcome measures were collected.</div></div><div><h3>Results</h3><div>Thirty-one patients receiving endoscopic LTN decompression were identified and included for analysis. The average follow-up was 25.1 ± 10.9 months, with an average patient age of 45.2 ± 18.1 years. Fifteen (n = 15/31; 48.4%) had prior ipsilateral upper-extremity surgery. Nineteen (n = 19/31; 61.2%) patients received a concomitant pectoralis minor release, 11 (n = 11/31; 35.5%) arthroscopic brachial plexus neurolysis, 10 (n = 10/31; 32.2%) arthroscopic scapulothoracic decompression, and 2 biceps tenodesis (n = 2/31; 6.5%) at the time of their arthroscopic LTN decompression. Visual analog scores (VAS) (7.7 ± 2.1 vs. 2.7 ± 2.7; <em>P</em> &lt; .001) and subjective shoulder value (38.0 ± 24.2% vs. 85.6 ± 8.2%; <em>P</em> = .02) significantly improved after surgery. Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form 7a (<em>P</em> = .35), PROMIS global physical (<em>P</em> = .58), PROMIS mental health (<em>P</em> = .65), and quick disabilities of the arm, shoulder, and hand (<em>P</em> = .11) did not significantly change after surgery. Measured forward elevation (127 ± 41° vs. 157 ± 10°; <em>P</em> = .003), abduction (117 ± 29° vs. 136 ± 14°; <em>P</em> = .01), and external rotation (54 ± 19° vs. 58 ± 4°; <em>P</em> = .009) significantly improved after surgery, while internal rotation (L1 ± 3 levels vs. T11 ± 2 levels; <em>P</em> = .11) remained unchanged. There were 4 (n = 4/31; 12.9%) complications characterized as persistent pain after surgery. There was one revision endoscopic LTN release (n = 1/31; 3.2%). There was no predictive patient (age, sex, body mass index, American Society of Anesthesiologists score, smoking status, diabetes, prior ipsilateral surgery) or surgical (operating room time) factors predisposing to surgical complications using logistic regression.</div></div><div><h3>Conclusion</h3><div>Thoracic-based, endoscopic decompression of the LTN improves pain, patient-reported outcome measures, and range of motion with minimal complications. Further study is required to determine long-term pain relief and outcomes.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100629"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between testosterone replacement therapy and incidence of proximal humerus fractures in men: a matched retrospective analysis","authors":"Paul-Hugo Arcand BA ,&nbsp;Simbarashe J. Peresuh MD ,&nbsp;Joseph Confessore BS ,&nbsp;Edward J. Testa MD ,&nbsp;Matthew Quinn MD ,&nbsp;Manjot Singh BS ,&nbsp;Gabriella J. Avellino MD ,&nbsp;Alan H. Daniels MD ,&nbsp;Michel A. Arcand MD","doi":"10.1016/j.xrrt.2025.100631","DOIUrl":"10.1016/j.xrrt.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Anabolic androgenic steroid supraphysiologic dose use is linked to an increased risk of tendon rupture. Testosterone replacement therapy (TRT) is used to treat hypogonadism and is associated with increased bone mineral density. However, its relationship with fracture risk, particularly proximal humerus fractures (PHF), remains uncertain. This study evaluates the association between TRT and the incidence of PHFs using a large national database. We hypothesized that TRT use would be associated with a difference in the incidence of PHFs compared to a control group due to testosterone's role in maintaining bone mineral density.</div></div><div><h3>Methods</h3><div>This retrospective study with one-to-one matching queried the PearlDiver Mariner165 dataset to obtain a random sample of 500,000 patients aged 35 to 75 who received TRT continuously for at least 3 months and a random control sample of 500,000 different patients. Of the targeted 1,000,000 patients, 335,753 pairs of patients were matched based on age, tobacco use, diabetes history, and the Charlson Comorbidity Index. Incidence of PHF was assessed over a 2-year follow-up using the International Classification of Diseases codes, with comparisons made across the different cohorts. Multivariable logistic regression was conducted to identify the association between TRT use with PHF in men. An alpha level of 0.01 was prespecified to reduce the risk of type I error and ensure statistical rigor.</div></div><div><h3>Results</h3><div>In this matched-cohort study of 335,753 paired TRT and control patients, the mean age was 53.82 ± 10.58 years. Patients administered TRT demonstrated a higher incidence of PHF compared to the control cohort (0.029% vs. 0.005%, <em>P</em> &lt; .001). Logistic regression analysis demonstrated that TRT was associated with a significantly increased risk of PHF (adjusted odds ratio 3.14; 95% confidence interval: 1.84-5.59; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>In this retrospective matched-cohort study, TRT patients demonstrated an increase in 2-year incidence rates of PHF in men. These findings underscore the need for tailored patient management and provide actionable insights for orthopedic practice. Future studies of prospective design are needed to better address confounding factors, establish causation, and evaluate surgical outcomes in TRT patients.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100631"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of a proximal humerus nonunion with an extramedullary calcar replacing iliac crest autograft: surgical technique and review of the literature","authors":"Bradley W. Fossum MD,&nbsp;Daniel Z. You MD, MSc, FRCSC,&nbsp;Samuel S. Rudisill MD,&nbsp;Joaquin Sanchez-Sotelo MD, PhD","doi":"10.1016/j.xrrt.2025.100626","DOIUrl":"10.1016/j.xrrt.2025.100626","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100626"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allograft strut–screw construct in the management of total elbow periprosthetic fractures: a surgical technique with high complication rate","authors":"Julia C. Mastracci MD ,&nbsp;Nainisha Chintalapudi MD ,&nbsp;James Tyler Frix MD ,&nbsp;R. Glenn Gaston MD ,&nbsp;Bryan J. Loeffler MD","doi":"10.1016/j.xrrt.2025.100627","DOIUrl":"10.1016/j.xrrt.2025.100627","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100627"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of engaging reverse Hill-Sachs lesions with press-fit large fresh osteochondral allografts: a technical note","authors":"Jamal Zahir BS,&nbsp;Kassem Ghayyad MD,&nbsp;Daniel Goltz MD,&nbsp;G. Russell Huffman MD, MPH, FAAOS","doi":"10.1016/j.xrrt.2025.100620","DOIUrl":"10.1016/j.xrrt.2025.100620","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 1","pages":"Article 100620"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-stage early reconstruction for neglected elbow dislocation with heterotopic ossification","authors":"Ryosuke Sato MD ,&nbsp;Tomohiro Goto MD, PhD ,&nbsp;Tetsuya Enishi MD, PhD ,&nbsp;Michihiro Takai MD, PhD ,&nbsp;Yasuyuki Omichi MD, PhD ,&nbsp;Yusaku Nakayama MD ,&nbsp;Gakuto Yoshida MD ,&nbsp;Shunji Nakano MD, PhD ,&nbsp;Koichi Sairyo MD, PhD","doi":"10.1016/j.xrrt.2025.100619","DOIUrl":"10.1016/j.xrrt.2025.100619","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 1","pages":"Article 100619"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of hemiarthroplasty for complex proximal humerus fractures: a systematic review of clinical studies with minimum 10-year follow-up","authors":"Logan D. Moews BS ,&nbsp;Lord J. Hyeamang BA ,&nbsp;Alexander L. Hornung MD ,&nbsp;Tomas F. Vega MD ,&nbsp;Jacob T. Morgan BA ,&nbsp;Amelia Hummel MD ,&nbsp;Matthew E. Henriques MD ,&nbsp;Andrew S. Bi MD ,&nbsp;Nikhil N. Verma MD","doi":"10.1016/j.xrrt.2025.100616","DOIUrl":"10.1016/j.xrrt.2025.100616","url":null,"abstract":"<div><h3>Background</h3><div>While hemiarthroplasty (HA) has decreased in use as a surgical treatment for complex proximal humerus fractures, its long-term performance remains poorly defined. This systematic review evaluates clinical and functional outcomes and complication rates following HA with minimum 10-year follow-up.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and Scopus was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify clinical studies reporting ≥10-year outcomes of HA for acute complex (3- or 4-part, fracture dislocations, or head split) proximal humerus fractures. Included studies reported functional or patient-reported outcomes and had a minimum average follow-up of 10 years. Study quality was assessed using the Methodological Index for Non-Randomized Studies criteria.</div></div><div><h3>Results</h3><div>Five studies encompassing 198 patients met the inclusion criteria. Mean follow-up ranged from 10.3 to 20.5 years. Postoperative Constant scores ranged from 63.9 to 82.8. Mean forward flexion ranged from 100.0° to 126.0°, and external rotation ranged from 28.0° to 46.0°. Greater tuberosity healing rates ranged from 30.0% to 91.0%, with improved clinical outcomes associated with anatomic healing at the greater tuberosity. Failure rates ranged from 0% to 29%, most commonly due to tuberosity malunion or nonunion. Glenoid erosion was reported in up to 72.7% of patients at a mean follow-up of 20.3 years. The overall complication (range, 0%-3.2%) and reoperation (range, 0%-12.9%) rates were low. Most failures were converted to reverse total shoulder arthroplasty.</div></div><div><h3>Conclusion</h3><div>HA for the treatment of complex proximal humerus fractures yields variable long-term clinical outcomes and high rates of failure, with the majority due to greater tuberosity malunion or nonunion. Anatomic greater tuberosity healing appears to result in improved function and lower failure risk. These findings suggest limited utility of HA in the long term, supporting the need for careful patient selection and consideration of alternative surgical options such as reverse shoulder arthroplasty for treatment of complex proximal humerus fractures.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 1","pages":"Article 100616"},"PeriodicalIF":0.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}