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. 2023 Feb 22;12(5):1762.
doi: 10.3390/jcm12051762.

The Influence of Adherence to Orthosis and Physiotherapy Protocol on Functional Outcome after Proximal Humeral Fracture in the Elderly

Evi Fleischhacker  1 , Johannes Gleich  1 , Vera Smolka  1 , Carl Neuerburg  1 , Wolfgang Böcker  1 , Tobias Helfen  1
Affiliations

The Influence of Adherence to Orthosis and Physiotherapy Protocol on Functional Outcome after Proximal Humeral Fracture in the Elderly

Evi Fleischhacker et al. J Clin Med. .

Abstract

In the treatment of proximal humeral fractures (PHF), patients are often recommended to wear a sling or orthosis and to perform physiotherapy. However, some patients, especially elderly ones, struggle to comply with these rehabilitation regimens. Therefore, the aim of the study was to evaluate whether these incompliant patients have a worse functional outcome than those who adhere to the rehabilitation protocol. After receiving a diagnosis of a PHF, patients were divided into four groups according to fracture morphology: conservative with sling, operative with sling, conservative with abduction orthosis, and operative with abduction orthosis. At the 6-week follow-up, compliance regarding brace use and physiotherapy performance were assessed, as well as the constant score (CS) and complications or revision surgeries. The CS as well as the complications and revision surgeries were also surveyed after one year. In 149 participants, with a mean age of 73.9 ± 7.2 years, only 37% terminated orthosis and only 49% underwent physiotherapy as recommended. The statistical analysis showed no significant difference in the CS, complications, and revision surgeries between the groups.

Keywords: elderly; proximal humeral fracture; rehabilitation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Boxplot of the CS [points] according to compliance collectives.
Figure 2
Figure 2
Reasons for early termination of orthosis therapy.
Figure 3
Figure 3
Case of a 72-year-old man of group [C] with an AO 11-B2 fracture, (A) anteroposterior X-ray from the fracture day. Patient-related termination of orthosis protocol after 96 h. (B) Anteroposterior X-ray after 6 weeks with acceptable healing and CS above the average value of 70 points.
See this image and copyright information in PMC

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