Non-operative Treatment in Sweden of Proximal Humeral Fractures

Non-operative Treatment in Sweden of Proximal Humeral Fratures, a Randomised Multicenter Trial.

Proximal humeral fractures are common especially in the elderly population. The majority of these fractures are minimally displaced and may be treated non-operatively. There is however a controversy about which fractures that need surgery and randomised trials have not been able to show a clinically important advantage in patient reported outcome measures for those operated. The trend is therefore that also displaced and comminute fractures are treated non-operatively. There is however very little scientific support for how the non-operative treatment should be designed and performed. Therefore this prospective multicenter study is aiming at investigating the benefit of a four week immobilisation orthosis as compared to early range of motion exercises for those patients not assigned for surgery one week after the trauma.

Inclusion Criteria:

• A proximal humeral fracture verified on radiology no older than 7-10 days.

Exclusion Criteria:

• Surgically treated proximal humeral fracture
• Fracture only involving the greater tuberosity
• Previous surgery in the fractured shoulder
• Ongoing malignancy in the fractured shoulder
• Neurologic disease
• Radiating pain from the neck in the affected arm
• Associated vascular or nerve injuries
• Dementia
• Alcohol abuse
• Unwilling to participate in the trial