A Scoping Review of Biomechanical Testing for Proximal Humerus Fracture Implants

David Cruickshank; Kelly A. Lefaivre; Herman Johal; Norma J. MacIntyre; Sheila A. Sprague; Taryn Scott; Pierre Guy; Peter A. Cripton; Michael McKee; Mohit Bhandari; Gerard P. Slobogean


BMC Musculoskelet Disord. 2015;16(175) 

In This Article


Literature Search

As part of our larger proximal humerus fracture scoping review (Slobogean et al.,[13]), we completed a comprehensive literature search to identify studies on the management of proximal humerus fractures. In consultation with a biomedical librarian, we developed a sensitive search strategy to identify all types of publications involving proximal humerus fractures. Using a combination of keywords and medical subject heading (MeSH) terms related to proximal humerus fractures, we searched the following electronic databases: Medline, Excerpta Medica Database (EMBASE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews (CDSR), Proquest, Web of Science, Society of Automotive Engineers (SAE) digital library, and Transportation Research Board's Transport Research International Documentation (TRID) database. All searches were performed in October 2012, and no language or date restrictions were employed.

Study Selection

All identified titles were then compiled into a literature review program (DistillerSR), and an independent review process was performed. All studies were reviewed in duplicate by two orthopaedic surgeons, and studies involving biomechanics were identified. We excluded review articles, computer modeling, finite element analysis studies, and studies that were not published in English.

Data Abstraction

Two authors (DC and TS) independently abstracted data from each included study focusing on the characteristics of the analysis and the methods utilized to better understand the layout of the literature. Any disagreements on the data abstracted were resolved by consensus in consultation with a third author (GPS). Study characteristics abstracted included publication year, geographic location, sample size, and type of specimen. Methods data abstraction examined pretesting analysis, implant selection, and testing conditions.

Statistical Analysis

Descriptive statistics were used to summarize all data. For continuous data, the mean and standard deviation or median and ranges were reported based on the data's distribution. Counts and proportions were used to describe all other data. No inferential statistical testing was performed.