Interventions for treating proximal humeral fractures in adults (Review)

selection, timing and duration of all interventions. In particular,
there is a need to determine if a simple undisplaced fracture should
be immobilised, and if so, for how long, and the timing, type
and extent of physiotherapy required. There is an urgent need to
define more clearly the role and type of surgical intervention in
the management of proximal humeral fracture. Any trials must
take account of the important issues of method of randomisation,
blinding and duration of follow up. Such trials should use standard
and validated outcome measures, including patient assessed
functional outcomes, and also assess resource implications.
This Cochrane review should be maintained and updated as further
randomised controlled trials become available. The authors
would be pleased to receive information about any other randomised
controlled trials relating to the treatment of fractures of
the proximal humerus.
A C K N O W L E D G E M E N T S
We thank Alastair Gibson for his substantial contributions to the
first four versions of this review.
We thank Panos Thomas for his contribution to the protocol, and
Linda Digance, Christopher Muller and Sonia Stewart for for-
References to studies included in this review
Bertoft 1984 {published data only}
Bertoft ES, Lundh I, Ringqvist I. Physiotherapy after fracture of the
proximal end of the humerus. Comparison between two methods.
Scandinavian Journal of Rehabilitation Medicine 1984;16(1):11–6.
Hodgson 2003 {published and unpublished data}
Campbell M. Early versus late physiotherapy in fractured proximal
neck of humerus: a randomised controlled study. In: National
Research Register, Issue 3, 2000. Oxford: Update Software.
Hodgson S, Stanley D. A randomised controlled trial investigating
functional outcome, with early and late physiotherapy, on patients
sustaining a fractured proximal humerus. British Elbow and
Shoulder Society (BESS) Annual Scientific Meeting and
Instructional Course; 2000 May 4-5; Nottingham (UK). 2000.
Hodgson S, Stanley S, Mawson S. Timing of physiotherapy in
management of fractured proximal humerus: Randomised
controlled trial [Abstract]. Physiotherapy 2002;88(12):763.
Hodgson S, Stanley S, Mawson S. Timing of physiotherapy in the
management of the fractured proximal humerus: a randomised
controlled trial. Extending the boundaries. Chartered Society of
Physiotherapy Congress 2001; 2001 Oct 19-21; Birmingham
(UK). 2001.
Hodgson SA. A controlled, randomised study investigating
functional outcome, with early and late physiotherapy, on patients
following a fractured proximal humerus. National Research
R E F E R E N C E S
Interventions for treating proximal humeral fractures in adults (Review)
Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
eign translations. We thank Bill Gillespie, Peter Herbison, Leeann
Morton, David Sonnabend, John Stothard, Marc Swiontkowski
and Janet Wale for their help at editorial review of the first version.
We thank David Sonnabend for sharing his observations on the
second version, and Bill Gillespie for his suggestions for incorporating
these into the third version. We thank Lesley Gillespie,
Peter Herbison, Nicola Maffulli and Janet Wale for their help at
editorial review of the fourth version. We thank Joanne Elliott, Bill
Gillespie, Lindsey Shaw and Janet Wale for their contributions at
editorial review of the fifth version.
We thank the following for further information on their research
in this area: Cathy Booth, Peter Brownson, Piet de Boer, Joe Dias,
Tore Fjalestad, Mark Flannery, Tim Hems, Stephen Hodgson, Roo
Kulkarni, Shea Palmer, Rajiv Sharma and Robin Turner.
We thank Lesley Gillespie for her help in developing the revised
search strategy and trial retrieval for the updates and advice on
presentation. We thank Laurent Audige of the AO-ASIF Foundation
and Anette Blümle of the German Cochrane Centre for the
supply of several trial reports.
Helen Handoll’s work on the first version of the review was supported
by the Chief Scientist Office, Department of Health, The
Scottish Office, UK. Her work on the first and second updates was
supported by the East Riding and Hull Health Authority, UK.
Register (http://www.update-software.com/National/nrrframe.html)
2000, issue 3.
∗ Hodgson SA, Mawson SJ, Stanley D. Rehabilitation after twopart
fractures of the neck of the humerus. Journal of Bone and Joint
Surgery. British Volume 2003;85(3):419–22.
Stanley D. A prospective, controlled, randomised study
investigating functional outcome, with early and late physiotherapy,
on patients following a fractured proximal humerus. In: National
Research Register, Issue 2, 2001. Oxford: Update Software.
Hoellen 1997 {published data only}
Bauer G, Hoellen I, Hohlbein O. Primary prosthetic humerus head
replacement in dislocated multiple fragment fracture of the
humerus head in over 60-year-olds [Der primare prothetische
Humeruskopfersatz bei der dislozierten
Humeruskopfmehrfragmentfraktur bei uber 60jahrigen]. Hefte zur
der Unfallchirurg 1999;272:169–70.
∗ Hoellen IP, Bauer F, Holbein O. Primary endoprosthesis in
comminuted fractures of the proximal humerus - an alternative
treatment for elderly patients? [Der prothetische humeruskipfersatz
bei der dislozierten humerusmehrfragmentfraktur des alten
menschen – eine alternative zur minimalosteosynthese].
Zentralblatt fur Chirurgie 1997;122(11):994–1001.
Hoellen IP, Holbein O, Bauer G. Prosthetic humerus head
replacement in dislocated humerus head multiple fracture in older
people: An alternative to minimal osteosynthesis? [Der
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