RecruitingNCT06133920

Duration of Immobilization After Reverse Total Arthroplasty for Proximal Humerus Fractures

Immobilization Versus Early Range of Motion in Reverse Total Arthroplasty in Patients With Proximal Humerus Fractures

Sponsor

The Cooper Health System

Enrollment

40 participants

Start Date

Feb 24, 2021

Study Type

OBSERVATIONAL

Conditions

Reverse Total Shoulder Arthroplasty Proximal Humeral Fracture

Summary

The purpose of this study is to evaluate compare postoperative range of motion in patients who are given a sling for comfort only and allowed to start early active range of motion compared to patients who are placed in a sling for 4 weeks with passive range of motion only. Once enrolled, the patients will be randomized through computer randomization then placed in paper packets into either the immobilization group or the early range of motion group.

Eligibility

Min Age: 60 Years

Inclusion Criteria3

Patients 60 years or older who have a displaced proximal humerus fracture
Meets surgical criteria for a reverse total shoulder arthroplasty
Receive surgical intervention within 6 weeks of initial injury

Exclusion Criteria4

Patients \<60 years in age
Patients who cannot undergo surgery due to medical comorbidities
Patients who receive surgical intervention after 6 weeks from initial injury
Patients who have preoperative nerve damage from their fractures that would limit the ability to move the arm postoperatively

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Interventions

OTHEREarly Range of Motion

The early range of motion group will be given a sling for comfort after their surgery. They will be told they can use their arm as tolerated and can remove the sling when comfortable immediately after surgery. They will be allowed to start passive range of motion, active assisted range of motion, and gentle active range of motion with therapy as tolerated with the exception of no internal rotation. They will also not be allowed to strengthen until 12 weeks after surgery. They will get formal physical therapy and be given a home exercise program as well that will be directed by their physical therapist

OTHERImmobilization

The immobilization group will be placed in a shoulder abduction sling immediately after surgery for four weeks. They will be allowed to start gentle passive range of motion with forward flexion to 120 degrees, abduction to 90 degrees, and external rotation to 30 degrees. They will receive a home exercise program and formal physical therapy with these limits. When they come out of the sling at four weeks they will start active range of motion and active assisted range of motion. They cannot internally rotate until 10 weeks after surgery. No formal strengthening until 3 months after surgery.