Early vs Delayed Physical Therapy (Exercises) for Non-Operatively-Treated Proximal Humerus Fractures: A Prospective Randomized Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Proximal Humeral Fractures
- Sponsor
- Massachusetts General Hospital
- Enrollment
- 63
- Locations
- 1
- Primary Endpoint
- Shoulder Flexion
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The purpose of the study is to compare two common ways of rehabilitating after proximal humerus fractures treated non-operatively.
Detailed Description
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.
Investigators
Neal Chung-Jen Chen
Principal Investigator; Hand Service
Massachusetts General Hospital
Eligibility Criteria
Inclusion Criteria
- •Male and Female patients.
- •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.
Outcomes
Primary Outcomes
Shoulder Flexion
Time Frame: 6 months
We measured active forward flexion of the shoulder
Secondary Outcomes
- External Rotation(3 months, 6 months)
- Abduction(3 months, 6 months)
- Disability of the Hand, Shoulder, and Arm Score(3 months, 6 months)
- Shoulder Pain Likert Scores(3 months, 6 months)