One-week X-ray control in acute proximal humeral fractures conservatively treated. Prospective randomized multicentric study.

Purpose Conservatively treated proximal humeral fractures (PHF) are often re-evaluated via X-ray after one-week to detect further displacements of the fracture that may require surgery. The objective of this study was to evaluate the need for a one-week X-ray evaluation of the conservatively treated PHF. Methods Prospective randomized multicentric study involving 4 centers that included the conservatively treated PHF. Patients were randomized to group I (one-week X-Ray assessment) and to group II (without X-ray assessment). Pain was assessed with the VAS at weeks 1 and 3 and at 3, 6,12 months. The Constant Score and Simple Shoulder Test were recorded at 6- and 12-months. Complications were also recorded at any point. Results A total of 143 patients were included. The mean age of the patients included was 69.01 years. There were 114 women and 29 men. There were 52 one-part, 58 two-part, 32 three-part and 1 four-part fracture. Group 1 consisted of 73 patients and 70 were allocated to group II. There were no significant differences between the two groups in terms of age, gender, dominance, and type of fracture. No statistically significant differences were noted between the 2 groups relative to the VAS at 1 week (p = 0.914), 3 weeks (p = 0.351), 3- (p = 0.229), 6- (p = 0.353), 12- month (p = 0.559). Neither were there any differences in the Constant Score at 6- (63.68 vs 64.22, p = 0.871), and 12-month (70.74 vs 70.82, p = 0.982) or the SST at 6 (p = 0.864) and 12-month (p = 0.319). Two patients in group I required further surgery. There were 8 complications (6 in group I, 4 in group II) (p = 0.945). Conclusions Based on the results of this study, a one-week control X-Ray is not necessary in conservatively treated PHF.