Feasibility of the PERFormance guided fracture Rehabilitation Method (PERFoRM) protocol for upper extremity fractures

Upper extremity fractures are increasingly common in Western Europe due to an aging population and rising osteoporosis rates. Treatment approaches vary significantly, influenced by fracture type, bone quality, and patient- surgeon preferences, with limited consensus on optimal rehabilitation. A key challenge is identifying when to initiate safe, early functional rehabilitation, as guidelines lack clarity on progressive mobilization.

A prospective observational study of operatively treated proximal humeral and distal radius fractures was performed. Feasibility was assessed through clinical observation of patient progress using patient- reported outcome measures and feedback from both medical and paramedical professionals.

Twenty patients and 10 professionals participated. Feasibility questionnaires indicated high protocol usability, though suggestions included simplifying it into a pocket card. Rapid functional improvement was observed within six weeks, with one complication (material failure) noted.

The PERFoRM protocol is safe and feasible, though larger-scale studies are needed. Future research should examine its applicability to a broader patient population, potentially extending to all upper extremity fractures except hand fractures.