Four trials compared early (usually one week) versus delayed (three or four weeks) mobilisation after fracture but only limited pooling was possible and most of the data were from one trial (86 participants). The quality of the evidence was either low or very low for all comparisons except the largest comparison.Nine trials evaluated non-surgical treatment in mainly minimally displaced fractures. Except for a large multicentre trial, bias in these trials could not be ruled out. The main exception was the surgical versus non-surgical treatment comparison tested by eight trials. Most of the 18 separate treatment comparisons were tested by small single-centre trials. MAIN RESULTS: We included 31 heterogeneous RCTs (1941 participants).
Only limited meta-analysis was performed. DATA COLLECTION AND ANALYSIS: Both review authors performed independent study selection, risk of bias assessment and data extraction. SELECTION CRITERIA: We considered all randomised controlled trials (RCTs) and quasi-randomised controlled trials pertinent to the management of proximal humeral fractures in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and other databases, conference proceedings and bibliographies of trial reports. OBJECTIVES: To assess the effects (benefits and harms) of treatment and rehabilitation interventions for proximal humeral fractures in adults.
#DIREQUAL REVIEW UPDATE#
This is an update of a Cochrane Review first published in 2001 and last updated in 2012. The management of these fractures varies widely. BACKGROUND: Fracture of the proximal humerus, often termed shoulder fracture, is a common injury in older people.
0 kommentar(er)
