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How long is the arm immobilised after a conservatively managed displaced proximal humerus fracture and does early mobilisation effect complication rates: A systematic review.

作者信息

Tunnicliffe H, Divall Pip, O'Neill Seth, Singh Harvinder, Wright David

机构信息

Physiotherapy Department, University Hospitals of Leicester, Leicester, UK.

Clinical Librarian Services, University Hospitals of Leicester, Leicester, UK.

出版信息

Shoulder Elbow. 2024 Oct;16(6):654-666. doi: 10.1177/17585732241239011. Epub 2024 Mar 18.


DOI:10.1177/17585732241239011
PMID:39552671
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11562216/
Abstract

BACKGROUND: Conservative management of displaced proximal humerus fractures involves a period of rest in a sling followed by physiotherapy. The aim of this review is to provide a narrative synthesis of how long immobilisation is used, types of slings, when and how exercises are introduced, and if complications may be associated with these components. METHOD: A systematic search of the literature was undertaken. Two researchers screened relevant articles using Covidence software, with a third reviewer consulted for consensus. Data was extracted and a narrative synthesis is presented. RESULTS: Thirty-nine studies were included (3059 studies screened, 159 full-text reviews). This included a cohort of 2664 patients with a mean age of 70.9. Time immobilised in sling ranged from 1 to 6 weeks. Sling types were variable and were grouped into low, medium and higher levels of support. Exercises were introduced at variable timescales tending to introduce passive and pendular exercises first. Complications were reported in 243 incidences (9.1%). DISCUSSION: There was vast variation in how long patients were immobilised for, types of slings used and when and how exercises were introduced and progressed. No relationship was found between complications and these components. Research to identify the most effective approach is required.

摘要

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[2]
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[3]
Comparison of the Neer classification to the 2018 update of the Orthopedic Trauma Association/AO fracture classification for classifying proximal humerus fractures.

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[4]
Interventions for treating proximal humeral fractures in adults.

Cochrane Database Syst Rev. 2022-6-21

[5]
Functional Outcome After Nonoperative Treatment of a Proximal Humeral Fracture in Adults.

J Bone Joint Surg Am. 2022-1-19

[6]
The influence of smoking and alcohol on bone healing: Systematic review and meta-analysis of non-pathological fractures.

EClinicalMedicine. 2021-10-31

[7]
PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews.

J Med Libr Assoc. 2021-4-1

[8]
One Versus 3-Week Immobilization Period for Nonoperatively Treated Proximal Humeral Fractures: A Prospective Randomized Trial.

J Bone Joint Surg Am. 2021-8-18

[9]
The Benefits and Harms of Early Mobilization and Supervised Exercise Therapy after Non-surgically Treated Proximal Humerus or Distal Radius fracture: A systematic Review and Meta-analysis.

Curr Rev Musculoskelet Med. 2021-4

[10]
Conservative treatment of 3-part and 4-part proximal humeral fractures: a systematic review.

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