Trends in reported outcomes and patient reported outcome measures (PROMs) in humeral shaft fracture literature: a systematic review

Purpose With a lack of standardization among outcome measures in fracture literature, cross-study comparisons remain limited. This systematic review aimed to identify trends in outcome measures reported by studies of the treatment of humeral shaft fractures. Methods A systematic review was performed...

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Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology 2024-08, Vol.34 (6), p.2859-2870
Main Authors: Portnoff, Brandon S., Byrne, Rory A., Hao, Kevin A., Gutowski, Caroline T., Lin, Yang, Hoffman, Ryan A., Fedorka, Catherine J., King, Joseph J., Green, Andrew, Paxton, E. Scott
Format: Article
Language:English
Subjects:
Clinical outcomes
Cohort analysis
General Review
Medicine
Medicine & Public Health
Surgical Orthopedics
Systematic review
Traumatic Surgery
Trends
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Summary:Purpose With a lack of standardization among outcome measures in fracture literature, cross-study comparisons remain limited. This systematic review aimed to identify trends in outcome measures reported by studies of the treatment of humeral shaft fractures. Methods A systematic review was performed of studies reporting clinical outcomes of humeral shaft fractures indexed in PubMed. Extracted data included demographics, fracture characteristics, treatment modalities, outcomes, patient reported outcome measures (PROMs), and journal characteristics. Cochran-Armitage tests and linear regressions were used to identify data trends. Pearson chi-square and Kruskal–Wallis tests were used for comparisons between studies. Results This review included 197 studies with outcomes of 15,445 humeral shaft fractures. 126 studies reported PROMs and 37 different PROMs were used. The Constant Score was most commonly reported (34% of studies), followed by ASES Score (21%), MEPS (21%), and DASH Score (20%). There was a significant increase in PROM usage over time ( p  = 0.016) and in articles using three or more PROMs ( p  = 0.005). The number of PROMs were significantly greater in prospective cohort studies and RCTs ( p  = 0.012) compared to retrospective cohort studies and case series ( p  = 0.044 for both). Post-treatment shoulder motion was reported in 43% of studies and 34% reported elbow motion. 86% of studies reported complications as an outcome parameter. Time to union and nonunion rate were published in 69% and 88% of studies, respectively. Conclusion This study identified increasing PROM usage over time and disparities in the reporting of outcomes in humeral shaft fracture literature requiring further validation and standardization of available outcome measures.
ISSN:1432-1068
1633-8065
1432-1068
DOI:10.1007/s00590-024-04039-w