Comparison of Early and Late Therapy for Adults With Non-Operatively Treated Proximal Humerus Fractures

Proximal humerus fractures with limited displacement and fractures that occur in older, less
active or infirm patients are treated non-operatively. There is a general impression,
supported by some data, that better function is obtained with immediate initiation of
shoulder exercises. However, there is some concern that this may contribute to nonunion of
the fracture and may be unnecessary. Some researchers have demonstrated better outcomes with
immediate rehabilitation with pendulum movements. Others have shown similar functional
outcomes when rehabilitation begins approximately a month after injury, or when radiographs
show signs of bone healing, and this delay is associated with lower rates of non-union and
malunion occurrence.

Inclusion Criteria:

- Male and Female patients.

- Any race

- Older than 18y

- Diagnosed with proximal humeral fracture clinically and confirmed by imaging studies:
X rays and/or CT Scans.

- Any type of proximal humeral fracture according to the Neer or AO classification
system.

- Patient should have received non-operative treatment.

Exclusion Criteria:

- Patients younger than 18 y.

- Patients with multiple other fractures.

- Patients that have received surgical treatment including closed reduction and
percutaneous fixation, open reduction and internal fixation (plates, screws, pins,
tension wire bands, cerclage wiring and/or intramedullary nailing) and/or articular
shoulder prosthesis.