Patient selection

Using both ICD-9 and ICD-10 diagnostic codes, patient data consisting of a diagnosis of proximal humerus fracture were first queried. Patients who received either operative or nonoperative treatment of the proximal humerus fracture within 1 month of initial trauma were included in this study to best represent acute decision-making management. These data were queried each year from 2010 through 2019. Only patients aged 65 years and older were included. Patients with prior history of malignancy and infection were excluded. Records regarding fractures of the isolated greater tuberosity, shaft, or distal humerus were not included. Patients who passed away during the examined study period or did not have active follow-up during this time were also excluded. Given that both RSA and TSA are coded using the same CPT code (CPT-23472), these operations were identified with ICD-9 and ICD-10 procedural codes as these codes allow for specificity. Similar to previous studies, the use of ICD procedural codes for the procedures instead of CPT-23472 allowed accuracy in identifying TSA versus RSA during the studied time period.8^,21^,22 A comprehensive list of all ICD and CPT codes used in this study are included in Supplementary Table S1.