Nonoperatively Treated Proximal Humerus Fractures: Randomized Trial of Immediate Versus Delayed Initiation of Exercises

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Bruinsma Wendy E; Goslings J. Carel; Schep Niels W. L.; Ring David

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Journal Paper

Paper Information

Journal: Archives of Bone and Joint Surgery Year:621 | Volume: | Issue: Page(s): 672-676

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Information Journal Paper

Title

Nonoperatively Treated Proximal Humerus Fractures: Randomized Trial of Immediate Versus Delayed Initiation of Exercises

Author(s)

Bruinsma Wendy E | Goslings J. Carel | Schep Niels W. L. | Ring David | Issue Writer Certificate

Keywords

ExercisesQ4

Nonoperative treatmentQ4

Proximal humerus fractureQ4

Abstract

Objectives: There is debate about when to start Exercises in the Nonoperative treatment of a Proximal humerus fracture. This randomized trial compared immediate and one-month delayed shoulder Exercises in the Nonoperative treatment of fractures of the proximal humerus. Methods: Twenty-six patients with a fracture of the proximal humerus who chose Nonoperative treatment were randomized to start pendulum Exercises within a few days and 24 were randomized to delayed Exercises and started with active self-assisted stretching 1 month after fracture. Three and six months after the injury, patients completed the Disabilities of the Arm Shoulder and Hand questionnaire to measure capability, a measure of pain intensity, and had motion measurements. Results: There was no significant difference in forward flexion (primary outcome) six months after injury between patients that started motion Exercises immediately compared to 1 month after injury (p = 0. 85). There was no difference in any motion measurement, pain intensity, upper extremity specific disability (DASH score) three or six months after injury. Conclusion: Delaying Exercises for a month does not affect recovery from Nonoperative treatment of a fracture of the proximal humerus. People can choose whether to start Exercises immediately or wait until they feel comfortable. Level of evidence: II

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