640
M. L. A. P. Schnackers et al.
Content description
Of the 6 eligible papers, 5 addressed physiotherapeutic/
occupational therapeutic rehabilitation after surgical
treatment of proximal humerus fractures (1, 2, 8–10)
and one addressed post-surgical physiotherapeutic/
occupational therapeutic rehabilitation of acetabulum
fractures (4). No paper describing the rehabilitation
of tibial plateau fractures met the selection criteria.
Background information about the protocols selected
is shown in Table I.
Proximal humerus fractures
Fig. 1. Flowchart paper selection.
full-text could be retrieved. After the evaluation in
step 3, another 61 articles were excluded, resulting in
6 eligible papers. A flowchart of the selection process
is shown in Fig. 1. No eligible information was found
on stakeholder sites or in standard textbooks.
In the selected papers, a rehabilitation specialist or
physical therapist supervised the post-surgical reha-
bilitation of proximal humerus fractures. According
to Compito et al. (8) the therapy was especially aimed
at: (i) recovery, and then (ii) preservation of motion
of the glenohumeral complex. All authors described a
general physiotherapy/occupational therapy training
programme, making no distinction between either
the complexity of the fracture, (surgical) reduction
or fixation type. The research group of Handoll et al.
(10) prescribed a physiotherapy/occupational therapy
protocol that was used for both post-surgical rehabilita-
tion and conservative treatment. The extent to which
the papers selected reported the post-surgical therapy
programme differs considerably, varying from a brief
description of the exercises (1, 9, 10) to a more speci-
fied protocol including exceptions where the protocol
explicitly should not be followed and the underlying
Table I. Background information protocols selected
Burton & Watters (1) Compito et al. (8) Cuomo &
Zuckerman (2) Handoll et al. (10) Moeckel et al. (9) Maurer et al. (4)
Year of publication
Country of origin 2006
UK 1994
USA 1994
USA 2015
UK 1992
USA 1997
Germany
Aim of paper To consider the common
classification systems,
investigations, relevant
anatomy and the more
commonly proposed
treatment regimen
together with the
preferred management
options of the senior
author To review the factors Not specified
associated with
success and failure of
arthroplasty for acute
shoulder trauma To evaluate the clinical
effective-ness and cost-
effectiveness of surgical
compared with non-
surgical treatment of
the majority of displaced
fractures of the proximal
humerus involving the
surgical neck in adults To present the
results with the use
of a new biomodular
prosthesis for
treatment of
fractures of the
proximal part of the
humerus To describe the
physio-therapeutic
treatment for
conservative and
surgical treatment of
acetabulum fractures
as provided at the
Berufsgenossen-
schaftlichen
Unfallklinik Tübingen
(Germany)
Target population
protocol Patients with proximal
humerus fractures Patients with acute
fractures of the
proximal humerus Patients with a
displaced 2- or
3-part proximal
humerus fracture Adults with a displaced
fracture of the proximal
humerus involving the
surgical neck Patients with a
displaced fracture
of the proximal part
of the humerus
after surgical
treatment with a
new biomodular
prosthesis Patients with
after surgical
or conservative
treatment of an
acetabulum fracture
Not specified* Not specified Not specified Not specified
Not specified* Not specified Four specialist
physiotherapists
Yes Not specified Not specified
Protocol
Not specified*
development group
Protocol externally Not specified*
reviewed by experts
prior to publication
*Authors refer to the protocol as described in ref 11.
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