PMID- 27861604
OWN - NLM
STAT- MEDLINE
DCOM- 20170626
LR  - 20181202
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 11
DP  - 2016
TI  - Effectiveness and Safety of Interventions for Treating Adults with Displaced 
      Proximal Humeral Fracture: A Network Meta-Analysis and Systematic Review.
PG  - e0166801
LID - 10.1371/journal.pone.0166801 [doi]
LID - e0166801
AB  - PURPOSE: Network meta-analysis (NMA) is a comparatively new evidence-based 
      technique in medical disciplines which compares the relative benefits associated 
      with multiple interventions and obtains hierarchies of these interventions for 
      various treatment options. We evaluated the effectiveness and safety of open 
      reduction and internal fixation (ORIF), hemiarthroplasty (HA), reverse shoulder 
      arthroplasty (RSA), intramedullary nailing (IN) and non-operative treatment (NOT) 
      of displaced proximal humeral fractures in adults using Bayesian NMA of data from 
      clinical trials. METHOD: PUBMED, EMBASE and CENTRAL in July 2016 were searched 
      and clinical trials that evaluated interventions for treating adults with 
      displaced proximal humeral fractures were identified. Methodological qualities of 
      studies were assessed by the Newcastle-Ottawa Scale and risk of bias using the 
      Cochrane Collaboration tool. RESULT: Thirty-four trials involving 2165 
      participants were included in the study. RSA had significantly the highest 
      Constant score and lower total incidence of complications than ORIF, HA and IN. 
      Moreover, RSA resulted in a lower incidence of additional surgery than ORIF and 
      IN. The rank of treatments in terms high Constant score was: RSA, ORIF, IN, NOT 
      and HA. The rank for reduction in total incidence of complications was: RSA, NOT, 
      HA, IN and ORIF. For lowering the risk of additional surgery, the rank was: RSA, 
      NOT, HA, IN and ORIF. CONCLUSION: RSA had the highest probability for improving 
      functional outcome and reduction in the total incidence of complications and 
      requiring additional surgery among the five interventions for treating adults 
      with displaced proximal humeral fracture.
FAU - Chen, Long
AU  - Chen L
AD  - Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 
      Sichuan, China.
AD  - Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang, 
      Guizhou, China.
FAU - Xing, Fei
AU  - Xing F
AD  - Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 
      Sichuan, China.
FAU - Xiang, Zhou
AU  - Xiang Z
AD  - Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 
      Sichuan, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20161118
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Combined Modality Therapy/adverse effects/methods
MH  - Fracture Fixation/adverse effects/methods
MH  - Fracture Fixation, Intramedullary/adverse effects/methods
MH  - Hemiarthroplasty/adverse effects/methods
MH  - Network Meta-Analysis
MH  - Postoperative Complications
MH  - Retreatment
MH  - Shoulder Fractures/*pathology/*therapy
MH  - Treatment Outcome
PMC - PMC5115806
COIS- The authors have declared that no competing interests exist.
EDAT- 2016/11/20 06:00
MHDA- 2017/06/27 06:00
PMCR- 2016/11/18
CRDT- 2016/11/19 06:00
PHST- 2016/07/23 00:00 [received]
PHST- 2016/11/03 00:00 [accepted]
PHST- 2016/11/19 06:00 [entrez]
PHST- 2016/11/20 06:00 [pubmed]
PHST- 2017/06/27 06:00 [medline]
PHST- 2016/11/18 00:00 [pmc-release]
AID - PONE-D-16-29469 [pii]
AID - 10.1371/journal.pone.0166801 [doi]
PST - epublish
SO  - PLoS One. 2016 Nov 18;11(11):e0166801. doi: 10.1371/journal.pone.0166801. 
      eCollection 2016.