Variations in surgical practice and adverse events following isolated proximal humerus fracture in adults – a comparative longitudinal cohort study of 53,852 patients from Denmark, England, and Sweden
Variations in surgical practice for isolated PHF exist between Denmark, England, and Sweden, with differences in overall IRs of surgery and preferred procedures. A complex interplay between hospitals, surgeons, healthcare systems, and evidence-based factors is likely to explain such variations. However, in all three countries, the IR of surgery, particularly for the use of locking plates, demonstrated a decline from 2013, coinciding with high-quality trials and meta-analyses suggesting that evidence-based factors are becoming more prominent in orthopaedic treatment decisions.
Authors
- Antti P. Launonen (ORCID: https://orcid.org/0000-0002-3125-0171)
- Matthew Lee Costa (ORCID: https://orcid.org/0000-0003-3644-1388)
- Helle Østergaard (ORCID: https://orcid.org/0000-0002-8986-044X)
- Jennifer C. E. Lane (ORCID: https://orcid.org/0000-0002-1729-8654)
- Hans E. Berg (ORCID: https://orcid.org/0000-0001-6475-8564)
- Jonathan Rees (ORCID: https://orcid.org/0000-0003-1818-5800)
- Li Felländer‐Tsai (ORCID: https://orcid.org/0000-0003-0693-6080)
- Abdul Rashid Qureshi (ORCID: https://orcid.org/0000-0003-0536-5327)
- Richard Craig (ORCID: https://orcid.org/0000-0003-0792-9288)
- Merete Nørgaard Madsen (ORCID: https://orcid.org/0000-0003-2420-0480)
- Dominic Furniss (ORCID: https://orcid.org/0000-0003-2780-7173)
- Stephen E. Gwilym (ORCID: https://orcid.org/0000-0002-1323-8646)
- Inger Mechlenburg (ORCID: https://orcid.org/0000-0001-5432-8691)
- Marianne Toft
Institutions
- Karolinska University Hospital (SE)
- Queen Mary University of London (GB)
- Tampere University (FI)
- Aarhus University (DK)
- Milton Keynes Hospital (GB)
- Nuffield Orthopaedic Centre (GB)
- Aarhus University Hospital (DK)
- Karolinska Institutet (SE)
- Regionshospitalet Viborg (DK)
- NIHR Oxford Musculoskeletal Biomedical Research Centre (GB)
- Regionshospitalet Silkeborg (DK)
- Pirkanmaa Hospital District (FI)
- Tampere University (FI)
Publication Details
- Journal
- BMC Medicine
- Published
- 2025-11-03
- DOI
- https://doi.org/10.1186/s12916-025-04414-2
- Primary Topic
- Shoulder Injury and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institute for Health and Care Research
- Versus Arthritis
- Medical Research Council