Comparing Four-Week Sling Immobilization Versus Early Movement After Reverse Total Shoulder Replacement for Older Adults With Broken Upper Arm Bones

What this Trial Is About

Researchers are evaluating the recovery of shoulder movement after reverse total shoulder arthroplasty in older adults with displaced proximal humerus fractures. The study compares two approaches using a sling for comfort only with early active range of motion allowed versus placing patients in a sling for four weeks with only passive range of motion. This research aims to understand if early movement affects recovery or increases complications, as limited data exists for fracture cases. Participants are randomly assigned to one of two groups after surgery. The immobilization group wears a shoulder abduction sling for four weeks and begins gentle passive motions within set limits. After four weeks, they start active motion but avoid internal rotation until 10 weeks and strengthening until three months. The early range of motion group uses a sling for comfort but can move the arm as tolerated immediately after surgery, starting passive, active assisted, and gentle active motion except internal rotation. Both groups receive formal physical therapy and home exercise programs. Participants will be evaluated at 2 weeks, 6 weeks, 12 weeks, 6 months, 1 year, and 2 years after surgery. Assessments include pain scores, shoulder function, range of motion, complications, and X-rays to check healing. Outcome data will be collected either in person or via email. No extra visits are required beyond standard care. The study will compare long-term recovery and complications between the two treatment approaches.

Duration of Immobilization After Reverse Total Arthroplasty for Proximal Humerus Fractures