Comparison of Early and Late Therapy for Adults With Non-Operatively Treated Proximal Humerus Fractures

Massachusetts General Hospital63 enrolled

Overview

The purpose of the study is to compare two common ways of rehabilitating after proximal humerus fractures treated non-operatively.

Proximal humerus fractures with limited displacement and fractures that occur in older, less active or infirm patients are treated non-operatively. There is a general impression, supported by some data, that better function is obtained with immediate initiation of shoulder exercises. However, there is some concern that this may contribute to nonunion of the fracture and may be unnecessary. Some researchers have demonstrated better outcomes with immediate rehabilitation with pendulum movements. Others have shown similar functional outcomes when rehabilitation begins approximately a month after injury, or when radiographs show signs of bone healing, and this delay is associated with lower rates of non-union and malunion occurrence.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Proximal Humeral Fractures

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Male and Female patients. * Any race * Older than 18y * Diagnosed with proximal humeral fracture clinically and confirmed by imaging studies: X rays and/or CT Scans. * Any type of proximal humeral fracture according to the Neer or AO classification system. * Patient should have received non-operative treatment. Exclusion Criteria: * Patients younger than 18 y. * Patients with multiple other fractures. * Patients that have received surgical treatment including closed reduction and percutaneous fixation, open reduction and internal fixation (plates, screws, pins, tension wire bands, cerclage wiring and/or intramedullary nailing) and/or articular shoulder prosthesis.

Locations (1)

Massachusetts General Hospital

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Shoulder Flexion

We measured active forward flexion of the shoulder

Time frame: 6 months

Secondary Outcomes

Shoulder Pain Likert Scores

Rated on a scale of 0-10, where 0 is no pain and 10 is severe pain.

Time frame: 3 months, 6 months

External Rotation

Time frame: 3 months, 6 months

Abduction

Time frame: 3 months, 6 months

Disability of the Hand, Shoulder, and Arm Score

Disability of the Hand, Shoulder, and Arm Score (DASH) is a measure of upper extremity physical function, with scores ranging from 0 to 100. A higher score indicates more physical impairment.

Time frame: 3 months, 6 months

Data from ClinicalTrials.gov

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