Effect of triamcinolone acetonide on stiffness after surgical treatment of proximal humerus fractures: a randomized...

The primary aim of this study was to determine the effectiveness and safety of an intraarticular triamcinolone injection for the treatment of stiffness after the operative treatment of proximal humerus fractures.

88 patients who underwent plate fixation for proximal humerus fractures were enrolled. The patients were randomly divided into two groups, with Group I receiving a glenohumeral injection of triamcinolone 8 weeks postoperatively and Group II receiving no injection postoperatively. Outcomes were measured and compared based on the range of motion (ROM) and functional scores. Follow-up outcomes were assessed at initial, 3, 6 and 12 months postoperatively and at the last follow-up. Shoulder trauma series were taken at every visit to evaluate the fracture healing. The mean follow-up period was 25.37 (± 3.85) months Group I and 24.24 (± 6.23) months for group II.

In both groups, the final outcome of the ROM and functional outcome was significantly better at last F/U than at postoperative 8 weeks. Group I had significantly better results than Group II at postoperative 3 and 6 month in terms of forward flexion, external rotation, and VAS for pain. Also, Group I showed better performance in terms of ASES and Constant score at postoperative 3 months. The fracture union rate did not differ between Groups I and II.

Postoperative glenohumeral injection of triamcinolone is a safe and effective treatment modality for shoulder stiffness after internal fixation of proximal humerus fractures during the early period of rehabilitation.