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How long is the arm immobilised after a conservatively managed displaced proximal humerus fracture and does early mobilisation effect complication rates: A systematic review
Tunnicliffe, Helen Divall, Pip Singh, Harvinder
Tunnicliffe, Helen
Divall, Pip
Singh, Harvinder
Abstract
Background: Conservative management of displaced proximal humerus fractures involves a period of rest in a sling followed by physiotherapy. The aim of this review is to provide a narrative synthesis of how long immobilisation is used,
types of slings, when and how exercises are introduced, and if complications may be associated with these components.
Method: A systematic search of the literature was undertaken. Two researchers screened relevant articles using Covidence
software, with a third reviewer consulted for consensus. Data was extracted and a narrative synthesis is presented.
Results: Thirty-nine studies were included (3059 studies screened, 159 full-text reviews). This included a cohort of 2664
patients with a mean age of 70.9. Time immobilised in sling ranged from 1 to 6 weeks. Sling types were variable and were
grouped into low, medium and higher levels of support. Exercises were introduced at variable timescales tending to introduce
passive and pendular exercises first. Complications were reported in 243 incidences (9.1%).
Discussion: There was vast variation in how long patients were immobilised for, types of slings used and when and how exercises were introduced and progressed. No relationship was found between complications and these components. Research to
identify the most effective approach is required.
MIDER Authors
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Date
2024-03-21
Type
Article
Subject
Displaced proximal humerus fracture, Conservative management, Nonoperative, Sling immobilisation, Physiotherapy, Early mobilisation
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Citation
Tunnicliffe, H., Divall, P., O’Neill, S., Singh, H., & Wright, D. (2024). How long is the arm immobilised after a conservatively managed displaced proximal humerus fracture and does early mobilisation effect complication rates: A systematic review. Shoulder & Elbow, , 17585732241239011. doi:10.1177/17585732241239011