title: Early versus late mobilization after hemiarthroplasty for proximal humeral fractures.
abstract: This randomized controlled trial compares 2 mobilization regimens after shoulder hemiarthroplasty for acute 3- and 4-part fractures. The aim was to establish whether the length of immobilization plays a role in the functional outcome, tuberosity healing, and subsequent range of motion. The same prosthesis and surgical technique were used. We recruited 59 patients into the study; 31 were randomized to early (2 weeks) mobilization and 28 to late (6 weeks) mobilization. Greater tuberosity migration was assessed with a series of radiographs, and the functional outcome was assessed with the Constant Shoulder Assessment and Oxford shoulder scores. Of the patients, 49 (mean age, 70 years) met the inclusion criteria and were followed up for 12 months. Greater tuberosity migration occurred in 3 cases in the early mobilization group and once in the late mobilization group (P > .10). There was no significant difference in the Constant Shoulder Assessment and Oxford scores between the 2 groups. Although there was a decreased incidence of tuberosity migration in the group undergoing late mobilization, this was not statistically significant.
authors.affiliation: Liverpool Upper Limb Unit, Royal Liverpool University Hospital, Liverpool, England.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Agorastides
authors.forename: Christos
authors.initials: C
authors.lastname: Sinopidis
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Meligy
authors.forename: Qi
authors.initials: Q
authors.lastname: Yin
authors.forename: Peter
authors.initials: P
authors.lastname: Brownson
authors.forename: Simon P
authors.initials: SP
authors.lastname: Frostick
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000379:methods*; D005260:Female; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000534:rehabilitation* / Q000601:surgery*; D013997:Time Factors