The feasibility, acceptability, safety, and effects of early weight bearing in humeral fractures - a scoping review.
Jia Hui Gan, Lindsay Bearne, Samuel Walters and 4 others
PMID 38753460WHAT IT FOUND
Early weight bearing after humeral fracture surgery may be feasible and safe, but the review found no standard protocol, no patient perspective, and no firm evidence of effect.
Key findings
01The included studies involved patients managed operatively after humeral fractures.
02Five studies reported positive outcomes in patients who had surgery and early weight bearing, but the review could not separate the contribution of early weight bearing from surgery or other rehabilitation.
03Safety was reported in only five studies, no study reported patient acceptability, and no standard timeframe or instructions were defined.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most included studies were retrospective, case series or surveys, and many had no comparison group. The evidence was limited to operative management, so it does not show what to do after non-operative humeral fractures. No study defined a clear early weight bearing timeframe. Patient perspectives on acceptability were not studied. Outcome measures and rehabilitation treatments were heterogeneous, so contributions of early weight bearing, surgery and other rehabilitation could not be separated. Data extraction was not fully double checked because of funding constraints.
Declared interests
An author received NIHR and Health Education England fellowship funding that enabled the scoping review. The authors stated the views are their own and not necessarily those of NHS, NIHR, HEE or Department of Health and Social Care.
The easy way to misread this
Do not read this as proof that early weight bearing improves fracture healing or function. The review included heterogeneous studies, and it could not separate early weight bearing from surgery or other rehabilitation.