Functional outcomes following conservative management of proximal humerus fractures: a single-centre prospective observational cohort study.
DOI:
https://doi.org/10.51168/baes4v08Keywords:
Proximal humerus fracture, conservative treatment, Constant-Murley score, Disabilities of the Arm, Shoulder and Hand (DASH), radiological union, shoulder functionAbstract
Background:
Proximal humerus fractures are frequent injuries, particularly among older adults, and many can be treated without surgery. Functional recovery after conservative management varies with fracture complexity, patient characteristics and rehabilitation timing.
Objectives:
To evaluate radiological union, pain reduction, shoulder function, range of motion, complications and factors associated with six-month functional outcomes following conservative management of proximal humerus fractures.
Methods:
This single-centre prospective observational cohort study included 60 adults with proximal humerus fractures managed conservatively at Government Medical College/Government General Hospital, Nizamabad, Telangana, India, from January to December 2025. Treatment consisted of sling immobilisation, analgesia and progressive rehabilitation. Pain, Constant-Murley score, Disabilities of the Arm, Shoulder and Hand score, shoulder movement and radiological union were assessed through six months.
Results:
The mean age was 58.7 ± 13.4 years; 56.7% were female. Low-energy falls caused 71.7% of injuries, and two-part fractures were most frequent (46.7%). Union occurred in 80.0% by 12 weeks, 95.0% by 16 weeks, and all patients by 20 weeks. The mean Constant-Murley score improved from 28.6 ± 8.4 at baseline to 77.8 ± 13.1 at six months, while the mean DASH score declined from 68.4 ± 12.3 to 15.7 ± 12.1. Good or excellent outcomes occurred in 66.7%. Complex fractures had poorer function, greater residual pain, and longer union times. Twelve patients (20.0%) experienced at least one complication, most commonly shoulder stiffness.
Conclusion:
Conservative management produced reliable union and meaningful functional improvement in most patients, particularly those with one- or two-part fractures.
Recommendations:
Early structured rehabilitation and close surveillance should accompany conservative treatment. Complex fractures require individualized counselling and more intensive follow-up.
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