Continuous Shoulder Activity Tracking after Open Reduction and Internal Fixation of Proximal Humerus Fractures

Abstract

Postoperative shoulder activity after proximal humerus fracture treatment could influence the outcomes of osteosynthesis and may depend on the rehabilitation protocol. This multi-centric prospective study aimed at evaluating the feasibility of continuous shoulder activity monitoring over the first six postoperative weeks, investigating potential differences between two different rehabilitation protocols. Shoulder activity was assessed with pairs of accelerometer-based trackers during the first six postoperative weeks in thirteen elderly patients having a complex proximal humerus fracture treated with a locking plate. Shoulder angles and elevation events were evaluated over time and compared between the two centers utilizing different standard rehabilitation protocols. The overall mean shoulder angle ranged from 11° to 23°, and the number of daily elevation events was between 547 and 5756. Average angles showed longitudinal change <5° over 31 ± 10 days. The number of events increased by 300% on average. Results of the two clinics exhibited no characteristic differences for shoulder angle, but the number of events increased only for the site utilizing immediate mobilization. In addition to considerable inter-patient variation, not the mean shoulder angle but the number of elevations events increased markedly over time. Differences between the two sites in number of daily events may be associated with the different rehabilitation protocols.

Digitalization in orthopaedics: a narrative review

“…These devices, like braces, prosthetics and implants with embedded sensors can measure movement, force, and posture, aiming to improve and individualize patient care ( 36 ). For the upper extremity, wearable sensor settings have shown to give relevant data on patients rehabilitative outcome after surgery, e.g., in humeral head fractures ( 37 ). The use of such telehealth technologies is advantageous in postoperative monitoring, not only with the ability to reach more patients and reduce costs but is also particularly applicable to patient populations in remote areas ( 38 ).…”

Advances in Biomechanics-Based Motion Analysis

“…Regarding the motion analyses of localized body components, both validated multibody models and FEMs have been used. Using multibody models, Herteleer et al [ 11 ] continuously monitored shoulder joint angles in patients after surgeries of humerus fractures, and examined the effects of different rehabilitation protocols, i.e., early postoperative mobilization vs. immobilization, on the shoulder joint motions. Similarly, Kwak et al [ 2 ] compared knee joint kinematics following two different protocols of total knee arthroplasty to evaluate the effectiveness of the treatments.…”