Table 1 The baseline characteristics of eligible trials and involved patients
Study | Region | Sample size | Age (years) | Male (%) | BMI (kg/m2) | DXA total body T score | Fracture pattern | Intervention | Control | Comparability of baseline characteristics | Follow-up (months) |
|---|---|---|---|---|---|---|---|---|---|---|---|
Zyto 1997 [18] | Sweden | 40 (20/20) | 74.0 | 12.5 | NA | NA | 3, 4 | ORIF (without strut graft) | Non-operative (sling for 7–10 days, then physiotherapy) | Balanced: age, gender, fracture, right: left side, dominant limb | 50.0 |
Olerud 2011 [19] | Sweden | 55 (27/28) | 76.7 | 14.5 | 26.7 | -1.5 | 4 | HA | Non-operative (sling for 2 weeks, then rehabilitation regimen) | Balanced: age, gender, EQ-5Dindex score, nondominant arm, BMI, DXA total body T score; imbalanced: cognitive function | 24.0 |
Olerud 2011 [20] | Sweden | 60 (30/30) | 73.9 | 18.3 | 26.3 | -1.3 | 3 | ORIF (with strut graft) | Non-operative (sling for 2 weeks, then physiotherapy) | Balanced: age, gender, cognitive function, EQ-5Dindex score, ADL, nondominant arm, BMI, DXA total body T score, and fracture type | 24.0 |
Zhu 2011 [21] | China | 51 (25/26) | 52.6 | 33.3 | NA | NA | 2 | IMN | ORIF (with strut graft) | Balanced: age, gender, dominant side, medial cortical comminution, interval between surgery and injury | 36.0 |
Cai 2012 [22] | China | 32 (13/19) | 71.6 | 15.6 | 27.7 | -1.2 | 4 | ORIF (with strut graft) | HA | Balanced: age, gender, cognitive function, EQ-5Dindex score, ADL, nondominant arm, BMI, DXA total body T score | 24.0 |
Boons 2012 [23] | Netherlands | 50 (25/25) | 78.2 | 6.0 | NA | NA | 4 | HA | Non-operative (sling for 6 weeks) | Balanced: age, gender, VAS pain, VAS disability | 12.0 |
Fjalestad 2014 [24] | Norway | 50 (25/25) | 72.6 | 12.0 | NA | NA | B2/C2 | ORIF | Non-operative (sling for 2 weeks, then rehabilitation regimen) | Balanced: age, gender, injured arm, dominant arm, fracture types, pre-fracture medical conditions, concomitant injuries, pre-fracture 15 D score, Constant score | 24.0 |
Sebastia-Forcada 2014 [25] | Spain | 62 (31/31) | 74.0 | 14.5 | NA | NA | 3, 4 | RTSA | HA | Balanced: age, gender, dominant side, neer fracture, rotator cuff | 28.5 |
Gracitelli 2016 [26] | Brazil | 72 (36/36) | 65.5 | 27.7 | NA | NA | 2, 3 | IMN | ORIF (with strut graft) | Balanced: age, gender, smoking, dominant arm, mechanism of injury, interval between surgery and injury, intraoperative rotator cuff, neer classification, coronal deviation, medial cortical comminution | 12.0 |
Chen 2016 [27] | China | 60 (30/30) | 66.0 | 46.7 | NA | NA | 4 | ORIF (with strut graft) | HA | Balanced: age, gender, dominant side, dual mineral absorptiometry, accident, length of calcar segment, displacement of medial hinge, glenohumeral dislocation, varus impacted, valgus impacted, the mean time between trauma and surgery; imbalanced: medial comminution, blood loss | 24.0 |
Launonen 2019 [28] | Finland, Sweden, Denmark, Estonia | 88 (44/44) | 72.5 | 9.1 | NA | NA | 2 | ORIF (with strut graft) | Non-operative (sling for 3 weeks, then rehabilitation regimen) | Balanced: age, gender, fracture type, dominant side, smoking, diabetes, neurological diseases, DASH, Oxford Shoulder Score, EQ-5Dindex score, 15D score | 24.0 |
Lopiz 2019 [29] | Spain | 59 (29/30) | 83.5 | 13.6 | NA | NA | 3, 4 | RTSA | Non-operative (sling for 3 weeks, then rehabilitation regimen) | Balanced: gender, dominant side, Charlson Comorbidity Index, fracture type; imbalanced: age | 12.0 |
Plath 2019 [30] | Germany | 68 (36/32) | 75.6 | 25.0 | NA | NA | 3 | IMN | ORIF (with strut graft) | Balanced: age, gender, right/left ratio, dominant side, ASA physical status classification, neer classification, AO classification | 12.0 |
Fraser 2020 [31] | Norway | 124 (64/60) | 75.2 | 10.5 | NA | NA | B2/C2 | RTSA | ORIF (with strut graft) | Balanced: age, gender, living situation, diabetes, smoking, ASA class, time from injury to operation, OTA/AO fracture, injured arm, diminant arm; imbalanced: type of injury | 24.0 |
Ramo 2020 [32] | Finland | 82 (38/44) | 49.0 | 53.7 | 27.9 | NA | A/B/C | ORIF (with strut graft) | Non-operative (sling for 3 weeks, then rehabilitation regimen) | Balanced: age, gender, weight, height, BMI, smoking, radial nerve, AO/OTA classification, fracture location, injury mechanism, dominant limb, preinjury DASH score, optional work module, optional sports or performing arts module, preinjury 15D score | 12.0 |
Helfen 2020 [33] | Germany | 60 (30/30) | 75.0 | 33.3 | NA | NA | 2 | IMN | ORIF (with strut graft) | Balanced: age, gender, time to surgery | 24.0 |
Jonsson 2021 [34] | Sweden | 84 (41/43) | 79.5 | 9.5 | NA | NA | 3, 4 | RTSA | HA | Balanced: age, gender, right side dominant, dominant side injured, EQ-5Dindex score, injury type, days from injury to surgery, duration of surgery in minutes, and study center | 24.0 |
Boyer 2021 [35] | France | 85 (43/42) | 73.7 | 28.2 | NA | NA | 3, 4 | IMN | ORIF (with strut graft) | Balanced: age, gender, injury type | 66.0 |