通过Meta分析了解肱骨近端骨折合并肩袖撕裂的发生率状况。

采用Meta分析对既往发表的有关肱骨近端骨折合并肩袖撕裂的文献进行归纳和统计学分析。检索时间为自建库至2025年3月1日。提取文献中的数据进行汇总，采用Stata 17.0软件进行分析。

共纳入15篇文献，提取肱骨近端骨折人群样本总量1 787例，累及肱骨近端骨折1 791例，合并肩袖撕裂的发生率为26.7%（95% CI: 20.1~33.2），其中男性发生率为22.6%，女性为27.4%（男女之间比较P>0.05）。根据肱骨近端骨折Neer分型进行分析，Neer 2部分骨折患者肩袖撕裂发生率为21.4%，Neer 3部分为34.8%，Neer 4部分为9.1%。根据肩袖撕裂累及的肌腱部位对冈上肌腱撕裂、冈上+冈下肌腱撕裂情况进行分析，肱骨近端骨折合并冈上肌腱撕裂患者发生率为9.4%，合并（冈上+冈下）肌腱撕裂患者发生率为3.7%（两者比较P<0.05）。以每10岁为一个年龄段，共分为5个年龄段，整体趋势呈现50岁以后随年龄增长肱骨近端骨折合并肩袖撕裂发生率增加。

肱骨近端骨折患者合并肩袖撕裂较为常见，合并肩袖撕裂患者无明显性别差异，Neer3部分骨折患者更容易发生肩袖撕裂，肩袖撕裂患者中冈上肌腱更易撕裂，50岁以上患者肱骨近端骨折合并肩袖撕裂发生率随年龄增长呈上升趋势。

Proximal humeral fractures are the third most common osteoporotic fractures in the elderly population, which can lead to severe shoulder pain, functional impairment, and a decline in quality of life. The incidence rate is significantly related to age. With the increase in age, bone mass decreases and osteoporosis develops, and its incidence rate gradually increases. The prevalence of rotator cuff tears in the general population also increases with age. Therefore, there may be a significant overlap between the two patient groups. The recovery of shoulder joint function in patients with proximal humeral fractures is significantly correlated with rotator cuff injury, and rotator cuff tears affect the selection of treatment plans for patients with proximal humeral fractures. Undetected rotator cuff tears in patients with proximal humeral fractures may be an important reason for poor therapeutic effect. Not only full-thickness tears, but also simple partial rotator cuff tears have a significant impact on functional prognosis. Compared with patients without rotator cuff injury, even the functional prognosis of patients with partially torn proximal humeral fractures at one-year follow-up is impaired.

To investigate the prevalence of rotator cuff tears in proximal humerus fractures via Meta-analysis.

Meta-analysis was used to summarize and statistically analyze the previously published literature on proximal humeral fractures combined with rotator cuff tears. The search period is from the establishment of the database to March 1, 2025. The data in the literature were extracted, summarized, and analyzed using Stata 17.0 software.

A total of 15 studies were included. A total of 1 787 samples of the population with proximal humeral fractures were extracted, involving 1 791 cases of proximal humeral fractures. The incidence of rotator cuff tears was 26.7% (95% CI: 20.1-33.2), among which the incidence was 22.6% in males and 27.4% in females (comparison between males and females, P> 0.05). Based on the Neer classification of proximal humeral fractures, the incidence of rotator cuff tears in patients with Neer 2 partial fractures was 21.4%, 34.8%, and 9.1%. The incidence of supraspinatus tendon tears and (supraspinatus + infraspinatus) tendon tears was analyzed based on the tendon sites involved in rotator cuff tears. The incidence of patients with proximal humeral fractures combined with supraspinatus tendon tears was 9.4%, and the incidence of patients with (supraspinatus + infraspinatus) tendon tears was 3.7% (P< 0.05 for comparison between the two). Taking every 10 years as one age group, it is divided into five age groups. The overall trend shows that after the age of 50, the incidence of proximal humeral fractures combined with rotator cuff tears increases with age.

Rotator cuff tears are relatively common in patients with proximal humeral fractures. There is no significant gender difference in patients with rotator cuff tears. Patients with Neer's three-part fractures are more prone to rotator cuff tears. Supraspinatus tendons are more likely to tear in patients with rotator cuff tears. The incidence of proximal humeral fractures combined with rotator cuff tears in patients over 50 years old increases with age.