Treatment of isolated greater tuberosity fractures: a scoping review
Notice bibliographique
Résumé
Background: There are no evidence-based guidelines to support the management of isolated greater tuberosity fractures. While the choice between nonoperative and operative treatment is generally based on the degree of fracture displacement, the definition of an acceptable displacement continues to be debated. Consequently, the ideal management of these fractures can be a therapeutic challenge. The objective of this study was to create an overview of the literature investigating the treatment of isolated greater tuberosity fractures. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines for scoping reviews (PRISMA-ScR). Electronic databases MEDLINE, EMBASE, SPORTDiscus, and CINAHL were systematically searched from inception to September 29, 2024. Original studies investigating the treatment of isolated greater tuberosity fractures were eligible for inclusion. Screening of studies was independently performed by 3 reviewers. Data items were extracted using a standardized charting form. Risk of bias of the included studies was assessed by 2 independent reviewers using the Newcastle-Ottawa Quality Assessment Scale. Results: 3.788 records were identified in the search, 296 were retrieved for full-text screening, of which 59 were included. No randomized controlled trials were identified. 88% of the included studies were retrospective and 98% had a moderate or high risk of bias. Most of the included studies investigated operative treatment of displaced fractures (defined as >5 mm) in patient populations with a mean age between 40 and 60 years. Few studies investigated nonoperative treatment and treatment in young (<40 years) or elderly (>60 years) patients. Detailed fracture characteristics were not consistently reported. Accordingly, the size of the fragment was reported in 8% of the included studies, fractures were subclassified into avulsion, split or depression type in 29% of the included studies, and the direction of fragment displacement was reported in 34% of the included studies. Conclusion: The literature regarding the treatment of isolated greater tuberosity fractures is comprised of studies with a moderate to high risk of bias and a lack of randomized controlled trials. A 5 mm fracture displacement threshold is often used to guide treatment, though it has not been validated in clinical studies. High-quality studies are needed to establish evidence-based guidelines and improve clinical decision-making.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,007 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».