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The Effect of the Timing of Postoperative Mobilisation After Locking Plate Osteosynthesis of Fractures of the Surgical Neck of the Humerus

Not Applicable
Terminated
Conditions
Humeral Fracture
Interventions
Procedure: Immediate mobilisation after locking-plate osteosynthesis
Procedure: Standard mobilisation after locking plate osteosynthesis
Device: Osteosynthesis with a locking plate (Philos)
Registration Number
NCT01524965
Lead Sponsor
University of Helsinki
Brief Summary

Open reduction and locking plate osteosynthesis is a commonly used and well-accepted treatment for displaced fractures of the proximal humerus. The shoulders tend to end stiff despite intensive rehabilitation, limiting the function of the upper extremity and decreasing the quality of life. The accepted postoperative mobilisation protocol includes passive exercises until six weeks postoperatively and active range of motion exercises after that. There is good evidence that conservatively treated fractures of the same site heal better and faster if mobilised immediately. The study compares "standard mobilisation" versus "immmediate mobilisation" in a prospective, randomized, controlled trial in order to find the optimal time-frame for physiotherapy to produce best possible results. Outcome measures are assessed at specific time points after the operation and comparisons between groups are made to follow the rate of recovery and end results.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
94
Inclusion Criteria
  • Age 18 years or older
  • Surgery can be performed within 10 days of injury
  • A dislocated (>1cm or 35 degrees) AO 11-A2, -A3, -B1 or -B2 fracture of the surgical neck of the proximal humerus with a possible fracture of the Tuberculum Majus
Exclusion Criteria
  • Glenohumeral dislocation
  • Fracture of the Tuberculum Minus
  • Open fracture
  • Additional fractures in the shoulder region
  • Other injuries requiring surgical treatment
  • Clinically significant injury of the brachial plexus or vasculature
  • Pathological fracture associated with cancer
  • History of a fracture of the clavicle, scapula or humerus, or history of a very significant disease or trauma of the shoulder region (hemiparesis, tumour, osteomyelitis, grave arthrosis etc)
  • Rheumatoid Arthritis in the shoulder requiring active treatment
  • Reduced co-operation or incapability for independent living (dementia, mental illness, drug- or alcohol abuse etc)
  • Unwillingness to accept some of the treatment options.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Immediate mobilisationOsteosynthesis with a locking plate (Philos)-
Immediate mobilisationImmediate mobilisation after locking-plate osteosynthesis-
Standard mobilisationStandard mobilisation after locking plate osteosynthesis-
Standard mobilisationOsteosynthesis with a locking plate (Philos)-
Primary Outcome Measures
NameTimeMethod
Disablities of Arm, Hand and Shoulder2 years

Validated patient-reported upper extremity function scale

Secondary Outcome Measures
NameTimeMethod
Constant Score3 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years

subjective and objective shoulder score

Simple Shoulder Test (SST)3 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years

another shoulder score

Pain in rest and motion (2 different values)3 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years

Numeric rating scale 0-10

Subjective satisfaction3 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years

Patient reported, Numeric Rating Scale 0-10

Quality of Life3 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years

Using the 15D instrument

Complications3 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years

Complications of surgery and postoperative phase

Trial Locations

Locations (1)

Töölö Hospital, Helsinki University Central Hospital

🇫🇮

Helsinki, Finland

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