Rehabilitation Following Displaced Proximal Humerus Fractures
Denmark60 participantsStarted 2022-05-05
Plain-language summary
Proximal humerus fractures (PHFs) are the third most common non-vertebral fractures in the elderly. Most elderly experience loss of function following a PHF regardless of treatment. A Cochrane review from 2015 concluded that surgical management is not superior to non-surgical management, and that the optimal non-surgical management after PHF is not known. Therefore, the aim of this study is to evaluate the effectiveness of usual rehabilitation care after displaced PHF compared with one-time physiotherapy instruction.
Who can participate
Age range60 Years
SexALL
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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
• Patients aged 60 years or above with displaced PHFs (Neer's definition) including 2-, 3-, or 4-part fractures after a low energy trauma will be recruited.
Prior to first visit in the outpatient clinic all patients with PHFs will be screened for eligibility based on initial radiographs and medical records by an experienced orthopaedic consultant (senior author SB) at Zealand University Hospital, Køge, Denmark. The senior author classifies fracture categories.
• Patients should be cognitively capable of answering patient-reported outcome measures.
Exclusion Criteria:
* Dependent on daily personal care for basic activities of daily living
* Diagnosed with dementia or institutionalized
* Does not understand written and spoken guidance in Danish
* Pathological fracture or previous fracture in the same proximal humerus
* Concomitant injury or fracture.
* Polytrauma, high-energy trauma, or multiple fractures
* Fracture dislocation or articular surface fracture
* Isolated tuberosity fracture
* Fractures not expected to heal by non-surgical treatment (no bony contact between head and shaft in both views)
* The senior author considers the patient unsuitable to attend the study for medical reasons (substance abuse, affective or psychotic disorders, apoplexy, chronic pain, malignant disease)
* Symptomatic glenohumeral osteoarthritis, rheumatoid arthritis, or rotator cuff-arthropathy