ProFHER2

PROximal Fracture of the Humrus: Evaluation by Randomisation Trial no. 2 (PROFHER-2 Trial):

A three-arm randomised controlled trial to assess the effectiveness and cost-effectiveness of reverse shoulder arthroplasty versus hemiarthroplasty versus non-surgical care for acute three and four-part fractures of the proximal humerus in patients over 65 years of age

Inclusion criteria

• Adult patients aged 65 years or over

• Radiographically confirmed acute three-part (including surgical neck) or four-part displaced fracture of the proximal humerus (Neer Classification) including headsplitting fractures of the humeral head and fracture dislocations

• Trial interventions can be provided within 5 weeks of injury

• Patient is deemed by the clinical care team to be fit for surgery

• Able to provide full informed consent

Exclusion criteria

• Patients who are unable to adhere to trial procedures or complete questionnaires

• Poly-trauma – where one or more additional fractures, which may affect the outcome measures for the trial, are present or other body-systems are affected

• Open fractures or fractures where there is severe soft tissue compromise requiring urgent surgery

• Pathological (other than osteoporotic) fractures