Clinical and Radiological Results of Conservative Treatments in Proximal Humerus Fractures.

NCT ID: NCT04675879

Last Updated: 2023-02-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-01

Study Completion Date

2023-02-23

Brief Summary

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In the investigators' prospective randomized study, the investigator will investigate the effect of different bandage types on functional and radiological results of proximal humerus fractures over 18 years of age, for whom conservative treatment is decided.

In recent studies, it has been shown that surgical treatment in proximal humerus fractures has a high complication rate and is also not superior to conservative treatments in terms of functional results. Therefore, the importance of conservative treatment is increasing day by day in this group of fractures, especially in elderly patients with high risk for surgery.

In these studies in the literature, the method in conservative treatment is not clearly specified, and the investigator will apply 3 different bandages to adjust the rotation of the shoulder in 3 different ways during the investigators' conservative treatment. The investigator will compare functional and radiological results between these groups.

Detailed Description

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Proximal humerus fractures, who are admitted to the investigators' emergency department and are decided to follow conservative follow-up criteria, will be given one of 3 different bandages (velpau bandage, classical shoulder arm sling, 30 degree padded shoulder arm sling) according to the previous randomization.

Routinely, at the 2nd week, 6th week, 12th week, 6th month and 12th month outpatient clinic controls, the patients will be seen and their X-ray and clinical satisfaction status will be checked. X-rays will be taken as classical ap / lateral and true ap.

At the end of the second week, which is absolute immobilization, elbow and wrist movements will begin. Afterwards, in the 6th week, according to the state of union with deltoid strengthening, passive and active shoulder joint range of motion exercises will be started.

At the end of the 12th month, the follow-up will be terminated, and in this control, the existing joint movements will be recorded by measuring the degrees of anterior elevation, abduction, external rotation in neutral, external rotation at 90 degrees and internal rotation. In addition, in this control, the values will be noted by taking the Constant, ASES, DASH and VAS Scores.

After all these values are noted for all 3 groups, statistical analysis between groups will be made for each variable and the result will be given.

In addition, if complications(non-union,mal-union,stiffness etc.) occur during conservative follow-up in the investigators' patients, they will be recorded and whether there is a statistically significant difference in complications between the groups will be investigated.

The investigators' aim in this study is to understand whether any of these 3 different bandage types, which are routinely used as an immobilization method in proximal humerus fractures, are superior to the other.

A study comparing immobilization methods could not be found in the literature. These bandage types, which have not been compared with their effectiveness, are used effectively all over the world. With this study, the investigator set this on a scientific basis and set the correct direction of the investigators' treatments as the investigators' main goal.

Conditions

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Proximal Humeral Fracture

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Previously randomized patients were divided into 3 groups to be treated with 3 different types of bandages.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
When the treatments are completed, those who will evaluate the clinical and radiological results will not know the treatment method.

Study Groups

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Velpau bandage (Group 1)

Patients with neer type 2, 3 or 4 proximal humerus fractures under conservative follow-up with velpau bandage.

Group Type EXPERIMENTAL

Shoulder arm bandage

Intervention Type DEVICE

Three different shoulder-arm bandage types

Shoulder arm sling (Group 2)

Patients with neer type 2, 3 or 4 proximal humerus fractures under conservative follow-up with shoulder arm sling.

Group Type EXPERIMENTAL

Shoulder arm bandage

Intervention Type DEVICE

Three different shoulder-arm bandage types

Padded shoulder arm sling (Group 3)

Patients with neer type 2, 3 or 4 proximal humerus fractures under conservative follow-up with padded shoulder arm sling with 30 degree abduction.

Group Type EXPERIMENTAL

Shoulder arm bandage

Intervention Type DEVICE

Three different shoulder-arm bandage types

Interventions

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Shoulder arm bandage

Three different shoulder-arm bandage types

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Neer type 2, 3 and 4 proximal humerus fractures suitable for conservative follow-up
* Patients older than 18 years

Exclusion Criteria

* Previous surgery in the ipsilateral shoulder area
* Fractured dislocation
* Patients with open phys line
* Patients with neurological problems affecting the upper extremity (MS, stroke, etc.)
* Patients with fracture-induced neurovascular problems
* Open fractures
* Patients who require surgery for any reason while follw-up (malunion, nonunion, etc.)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bezmialem Vakif University

OTHER

Sponsor Role lead

Responsible Party

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Murat Sarikas

Recident of orthopaedic surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mehmet Kapıcıoğlu

Role: STUDY_DIRECTOR

Bezmialem Vakif University

Locations

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Bezmialem Vakıf University

Istanbul, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Related Links

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https://doi.org/10.1186/s13018-020-01880-7

Manuel Soler-Peiro , Lorena García-Martínez , Luis Aguilella and Marcelino Perez-Bermejo . Conservative treatment of 3-part and 4-part proximal humeral fractures: a systematic review . Soler-Peiro et al. Journal of Orthopaedic Surgery and Research

https://doi.org/10.1371/journal.pmed.1002855

Operative versus non-operative treatment for 2-part proximal humerus fracture: A multicenter randomized controlled trial . PLOS Medicine

https://doi.org/10.1186/s12891-018-2223-3

Lisa Howard , Randa Berdusco , Franco Momoli , J. Pollock , Allan Liew , Steve Papp , Karl-Andre Lalonde , Wade Gofton , Sara Ruggiero and Peter Lapner . Open reduction internal fixation vs non- operative management in proximal humerus fractures: a prosp

Other Identifiers

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14052

Identifier Type: -

Identifier Source: org_study_id

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