Does an early mobilization and immediate home-based self-therapy exercise program displace proximal humeral fractures in conservative treatment? Observational study
| Autor: | Fernando Moreno-Mateo, Clarisa Simón-Pérez, Mario Martínez-Zarzuela, Virginia García-Virto, Héctor J. Aguado, Blanca Ariño, Elías Y. Bustinza, Paula S. Ventura, Miguel Ángel Martín-Ferrero |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Conservative Treatment 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Displacement (orthopedic surgery) 030212 general & internal medicine Early Ambulation Reduction (orthopedic surgery) Aged Retrospective Studies Aged 80 and over 030222 orthopedics biology business.industry General Medicine Middle Aged biology.organism_classification Home Care Services Exercise Therapy Surgery Radiography Self Care Conservative treatment Valgus Diaphysis Treatment Outcome medicine.anatomical_structure Shoulder Fractures Early mobilization Female Observational study Diaphyses business Greater Tuberosity |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 27:2021-2029 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2018.04.001 |
| Popis: | Background Nonoperative management of proximal humeral fractures (PHFs) is the most common treatment, but its functional outcome may improve with early mobilization. In frail osteoporotic patients, quick recovery of prefracture independency is mandatory. This study assessed fracture displacement in PHFs managed with conservative treatment after early mobilization and a home-based self-exercise program. Methods We retrospectively analyzed the radiologic displacement of fracture fragments of PHFs treated conservatively with early mobilization and a home-based self-exercise program. Results Included were 99 patients with 26 one-part, 32 two-part, 32 three-part, and 9 four-part PHFs managed conservatively, followed by early mobilization and a home-based self-exercise program. In the x-ray examinations, the head displaced from varus into valgus 55° ± 23° to 42° ± 22°, in the normal range of anatomic values. The medial hinge displaced from medial to the diaphysis (+1 ± 6 mm) to lateral to the head (−0.6 ± 6 mm). The greater tuberosity displaced cranially from −1 ± 7 mm to 2 ± 5 mm. The Constant score at the 1-year follow-up was 79.69 ± 16.3. Discussion and conclusions The home-based self-exercise program for conservative treatment of PHFs displaces the head-diaphysis angle and the medial hinge toward anatomic reduction, but there is a risk of greater tuberosity cranial displacement. Functional results are fairly good, allowing frail patients to keep on with their independency and life style. Because a large number of patients might need further physiotherapy, the quality of the home-based self-exercises should be supervised. |
| Databáze: | OpenAIRE |
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