Immediate Mobilization Compared with Conventional Immobilization for the Impacted Nonoperatively Treated Proximal Humeral Fracture

Lefèvre-Colau, Marie-Martine; Babinet, Antoine; Fayad, Fouad; Fermanian, Jacques; Anract, Philippe; Rören, Alexandra; Kansao, Jamal; Revel, Marie‐Pierre; Poiraudeau, Serge

doi:10.2106/jbjs.f.01419

Cited by 130 publications

(64 citation statements)

References 29 publications

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“…The studies included examined the effect of adjuvant therapy in addition to an exercise program, 5,11,12,28,29,44,47 they compared exercise with no intervention 21,33 or another treatment modality, 9,19,20,22,25,46 and a few compared the effects of different exercise approaches. 32,40,52 When exercise was applied across conditions, all but 1 study showed improvement within both treatment groups. 11 Some of these studies found no statistically significant difference between groups 12,28,29,47 ; however, without a control group, it is hard to decide whether the benefits shown in outcomes were in fact because of exercise or just time.…”

Section: Discussionmentioning

confidence: 91%

“…Some studies applied exercise across conditions and evaluated the effects of adjuvant modalities to an exercise program 5,11,12,28,29,44,47 (Supplementary Table I), whereas a few compared different exercise approaches and onset of exercise programs 32,40,52 (Supplementary Table II). Seven of the included studies compared exercise with other treatment modalities 9,19,21,22,25,33,46 (Supplementary Table III).…”

Section: Quantitative Assessmentmentioning

confidence: 99%

“…This heterogeneity, along with variance in choice of outcome measurements, unconventional reporting of results, or no inclusion of measurement error, led to the exclusion of 9 of the 17 studies that were reviewed. 5,9,11,21,25,28,29,32,47 Pain Three studies included pain as an outcome and compared the effects of exercise versus other treatments on pain levels. 19,22,33 Data were pooled by use of a random-effects model with an overall effect of e0.3, with negative values in favor of the exercise intervention as reduction in pain values.…”

Section: Quantitative Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis

Marinko

Chacko

Dalton

et al. 2011

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 91%

Section: Quantitative Assessmentmentioning

confidence: 99%

Section: Quantitative Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis

Marinko

Chacko

Dalton

et al. 2011

Journal of Shoulder and Elbow Surgery

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“…Pain was graded as none (no pain), mild (occasional pain with excessive use of the hand), moderate (persistent, but endurable pain), or severe (pain necessitating analgesic control). The patient graded the level of satisfaction as very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied, or very dissatisfied [15].…”

Section: Methodsmentioning

confidence: 99%

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Miyake

Murase

Moritomo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Corrective osteotomy using dorsal plates and structural bone graft usually has been used for treating symptomatic distal radius malunions. However, the procedure is technically demanding and requires an extensive dorsal approach. Residual deformity is a relatively frequent complication of this technique. Questions/purposes We evaluated the clinical applicability of a three-dimensional osteotomy using computeraided design and manufacturing techniques with volar locking plates for distal radius malunions. Patients and Methods Ten patients with metaphyseal radius malunions were treated. Corrective osteotomy was simulated with the help of three-dimensional bone surface models created using CT data. We simulated the most appropriate screw holes in the deformed radius using computer-aided design data of a locking plate. During surgery, using a custom-made surgical template, we predrilled the screw holes as simulated. After osteotomy, plate fixation using predrilled screw holes enabled automatic reduction of the distal radial fragment. Autogenous iliac cancellous bone was grafted after plate fixation. Results The median volar tilt, radial inclination, and ulnar variance improved from À20°, 13°, and 6 mm, respectively, before surgery to 12°, 24°, and 1 mm, respectively, after surgery. The median wrist flexion improved from 33°b efore surgery to 60°after surgery. The median wrist extension was 70°before surgery and 65°after surgery. All patients experienced wrist pain before surgery, which disappeared or decreased after surgery. Conclusions Surgeons can operate precisely and easily using this advanced technique. It is a new treatment option for malunion of distal radius fractures.

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“…In relazione alla gravità, in un arco di tempo che va dal 25°al 35°giorno, si realizzeranno gli accertamenti radiografici e quelli relativi alla stabilità clinica della frattura: fondamentale risulta la cooperazione tra chirurgo ortopedico e fisioterapista [6]. Studi in letteratura consigliano di cominciare con la dovuta cautela le mobilizzazioni passive in tempi precoci, mostrando buoni risultati già a un follow-up di tre mesi riguardo al dolore e ai risultati alla valutazione mediante Costant Score, in assenza del pericolo di complicanze quali il malconsolidamento o la scomposizione della zona di frattura [6,7]. Una volta accertata la stabilità, il chirurgo consente l'inizio della mobilizzazione passiva che, nel primo periodo, dovrà comunque avvenire in un arco di movimento protetto.…”

Section: Fratture Dell'estremo Prossimaleunclassified

Proximal humeral fracture and shoulder artroplasty: Rehabilitation treatment

Inglese¹,

Creta²,

Biondi³

2009

LO SCAL

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PROXIMAL HUMERAL FRACTURE AND SHOULDER ARTROPLASTY: REHABILITATION TREATMENTThe proximal humeral fractures need a specific and specialist rehabilitation approach for their treatment, both for conservative or after shoulder artroplasty surgical implant. There are many factors that may influence the final recovery of the patient; the localization of the fracture (intra or extra capsular fracture), its size, the extent of the trauma, the general clinical conditions of the patient, the quality of the shoulder tissue and its personal ability to heal, the rehabilitative tecniques used, patient motivations and psicological aspects and how much time the patient have got to spend to follow the rehabilitation project to reach specific functional goals. The ROM deficit is the more common complication after proximal humeral fracture. The causes may be lack of articular congruence (stabilized meccanical rigidity without pain) or retraction of the capsulo ligament structures (changeable tissutal rigidity with pain). In most clinical situations (except prosthesis) an early passive articular mobilization in a safe range of motion (reduced ROM, on a scapular plane and avoiding rotations) will be usefull, postponing active mobilization and muscolar reinforce when there will be a safe clinical and radiological heal of the fracture or the prosthesis implant will be stable. The rehabilitation treatment of the patient that underwent surgical procedure of prosthesis implant (total shoulder arthroplasty, endoprosthesis, reverse shoulder arthroplasty, resurfacing prosthesis) needs in any case to avoid manual traction of the gleno humeral articulation or articular pompages, manual stabilizzation of the scapula, and in the first post surgery month to save humerous from rotations. In the end the clinical monitoring of many parameters (range of motion, muscolar force and endurance, coordinated skills, sportive gesture, daily living activity and functionality) using validated clinical tests (isokinetic and isometric tests, aerobic and anaerobic thereshold, scale to evaluate the functionality and the state of psychological health) will permit to understand if and at wich level the functional goals have been reached and will allow to observe far off the functional outcome.

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Immediate Mobilization Compared with Conventional Immobilization for the Impacted Nonoperatively Treated Proximal Humeral Fracture

Abstract: Early mobilization for impacted nonoperatively treated proximal humeral fractures is safe and is more effective for quickly restoring the physical capability and performance of the injured arm than is conventional immobilization followed by physiotherapy.

Cited by 130 publications

References 29 publications

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Proximal humeral fracture and shoulder artroplasty: Rehabilitation treatment

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