Status:

RECRUITING

Two- Part Proximal Humerus - Conservative vs Operative

Lead Sponsor:

University Hospital, Akershus

Conditions:

Proximal Humerus Fracture

2 Part Fracture

Eligibility:

All Genders

60-85 years

Phase:

NA

Brief Summary

The proximal humerus fracture (PHFs) is the third most common fracture type in the elderly, and represents 5% of the overall fractures. The incidence is increasing. The purpose of the project is to co...

Detailed Description

The study-design is a single center single blinded randomized controlled trial (RCT) with 2 arms. Patients admitted to Akershus University Hospital (Ahus) with a displaced two-part proximal humeral fr...

Eligibility Criteria

Inclusion

  • The study-design is a single center single blinded randomized controlled trial (RCT) with 3 arms. Patients admitted to Akershus University Hospital with a displaced 2-part proximal humeral fracture of OTA/ AO group 11A2 or 11A3 in need of surgical treatment will be randomly allocated to two groups; conservative/ non-operative treatment or open reduction and internal fixation (ORIF). The patients allocated to ORIF will be randomly allocated to either the Philos plate (Synthes) or the Multiloc nail (Synthes).
  • Inclusion criteria
  • Patients \> 60 years and \<85 years
  • More than 50% displacement between head or shaft or 50⁰ angulation of the head against the shaft in Y-projection or more than 45 ˚ valgus or more than 30˚ varus of the Head Shaft Angle (HSA).
  • Patient with tuberculum majus or minor fractures which displaced \<5mm can be included as long as points 1 and 2 above are fulfilled.
  • Exclusion Criteria:
  • Refusal to participate in the study
  • Fracture more than 3 weeks old
  • No contact btw head and shaft
  • Ipsilateral damage that will influence the recovery and scoring systems
  • Incapability to protect osteosynthesis, i.e. use of crutches because of injury to lower extremity. This is up to the treating surgeon to decide
  • Pathological fracture or previous fracture of the same proximal humerus
  • Multitrauma or "multifractured patient"
  • Neurovascular injury
  • Open fracture
  • Noncompliance, dementia and/ or institutionalized
  • Congenital anomaly
  • Ongoing infectious process around the incision site for osteosynthesis
  • Systemic disease that may influence healing processes or scoring systems (in example Rheumatoid arthritis/Multiple sclerosis/ poorly controlled DM)
  • Fracture dislocation
  • Substance abuse
  • Inability to read and understand Norwegian
  • Patients not residing in our catchment area
  • Patients with a diameter of the humerus to small for nailing, will be allocated to the Philos-group.
  • Any medical condition that excludes surgical treatment, including patients with ASA 3 or 4 that are considered too ill to go through surgery.

Exclusion

    Key Trial Info

    Start Date :

    October 1 2020

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    October 31 2034

    Estimated Enrollment :

    50 Patients enrolled

    Trial Details

    Trial ID

    NCT04106674

    Start Date

    October 1 2020

    End Date

    October 31 2034

    Last Update

    October 25 2022

    Active Locations (1)

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    1

    Akershus University Hospital

    Lørenskog, Oslo County, Norway, 0587