Background: The incidence of proximal humeral fractures is increasing with time. There is continuing debate about the indications for surgical intervention for this relatively common injury. Baseline data on functional outcome is essential in order to study the effect of surgical intervention. Functional outcome scores provide reliable and valid judgments of health status and the benefits of treatment. During our preparation of a study proposal on this topic to the Health Technology Assessment Program recently, we noted the lack of such data on outcome scores in the current literature.

Aim: To assess the functional outcome using the Constant and Oxford scores in patients treated conservatively for proximal humeral fractures.

Methods: We prospectively studied 103 consecutive patients who were treated conservatively for proximal humeral fractures. Patient demographics, fracture type (Neer), hand dominance and comorbidity were recorded. Constant and Oxford shoulder scores were recorded 3 and 12 months post injury.

Results: The average Constant shoulder score for males was significantly higher (better outcome) and the Oxford shoulder score significantly lower (better outcome) as compared to females. The scores were not affected by hand dominance. Although the raw scores tended to be worse with 3 or 4 part fractures the difference in the mean scores between the various Neer fracture types did not reach convential levels of significance.

A trend towards lesser degrees of improvement in the outcome scores was noted with increasing age. The degree of improvement in the outcome scores was not affected by sex, limb dominance or fracture type (Neer’s classification).

Conclusion: This study indicates the average behaviour of the Constant and Oxford scores with conservative treatment of proximal humeral fractures. This data should help with sample size and power calculations when studying interventions for this injury. We hope that this data will provide a baseline to help inform future study designs on proximal humeral fractures.

Systematic studies are required to examine the effects on outcomes of alternative treatments and surgical techniques in the management of Orthopaedic conditions. Functional outcome scores provide reliable and valid judgments of health status and benefits of the treatment. We undertook a prospective study to assess the functional outcome in patients treated conservatively for proximal humeral fractures.

103 patients treated conservatively for a proximal humeral fracture were followed prospectively. Constant shoulder score and Oxford shoulder score were recorded at 3 months and 12 months follow-up.

A trend towards lesser degrees of improvement in the outcome scores was noted with increasing age. The degree of improvement in the outcome scores was not affected by sex, limb dominance or fracture type (Neer’s classification).

This information gives a guide to average behaviour in different groups of individuals with conservative treatment for proximal humeral fractures. We could then using this data postulate what would constitute a clinically relevant difference and calculate study numbers required while assessing other form of treatments for such fractures