Functional outcomes after nonoperative management of XXXX of the proximal humerus.

@entity1 @entity6342 @entity174
BACKGROUND: Prospective follow-up data after nonoperative treatment for @entity174 of the proximal humerus are scarce. We studied functional outcomes and rates of complication and failure after conservative management of these common injuries. MATERIALS AND METHODS: Consecutive @entity1 aged older than 18 years presenting to the emergency department of a large district hospital with an isolated, closed proximal @entity174 considered suitable for functional treatment by the surgeon on charge were enrolled in a prospective, externally monitored observational study. Surgeons were free to reduce the @entity174 and to prescribe any type of sling or brace. Active follow-up after 12 weeks, 6, and 12 months included plain radiographs, Constant score, and Disabilities of Arm, Shoulder and Hand (DASH) score. RESULTS: We enrolled 160 @entity1 (118 @entity1 ; mean age, 63.3 +/- 14.8 years), and 124 completed 1-year follow-up. There were 85, 71, and 4 AO 11 A, B, and C @entity174 , and 75 one-part, 60 two-part, 23 three-part, and 2 four-part and head-splitting @entity174 . After 1 year, the mean difference in Constant scores between the injured and contralateral shoulder was 8.2 (95% confidence interval [CI], 6.0-10.4). The mean difference in 1-year DASH scores to baseline assessment was 10.2 points (95% CI 7.3-13.1 points). The risk of delayed and nonunion was 7.0% (95% CI, 3.6%-12.3%). Four @entity1 subsequently underwent surgical fixation, and 5 had arthroscopic subacromial decompression. CONCLUSION: This study may provide reference values for future investigations and stresses ceiling effects that will make it difficult to demonstrate a significant advantage of surgical over nonoperative treatment in @entity1 with @entity6342 . LEVEL OF EVIDENCE: Level 4; Prospective case series without a control group.
