Abstract
<title>Abstract</title> <p> <bold>Purpose:</bold> As the population ages, the incidence of proximal humeral fractures (PHF) is rising, placing a significant burden on healthcare systems. While evidence increasingly supports conservative management over surgery, follow-up protocols remain unstandardized. This study evaluates whether routine one-week radiographic follow-up affects clinical outcomes or management decisions of patients who sustained a PHF conservatively treated. <bold>Methods</bold> : This multicenter randomized clinical trial included patients with conservatively treated PHF across four centers. Participants were randomized into Group I (routine one-week X-ray) or Group II (no one-week X-ray). The primary outcomes were the Constant Score and Simple Shoulder Test (SST) at 12 months. Secondary outcomes included pain (VAS) and the rate of secondary surgical interventions. <bold>Results:</bold> No significant differences were observed between groups in functional outcomes (Constant Score and SST) at 6 or 12 months. Pain levels remained comparable at all follow-up intervals. Routine X-rays in Group I rarely led to management changes, and omitting the early radiograph in Group II did not result in delayed complications or worse functional recovery. <bold>Conclusion:</bold> Routine one-week radiographic evaluation after PHF provides no clinical benefit in terms of functional recovery or treatment optimization. In the context of Value Based Healthcare (VBHC), eliminating this practice reduces unnecessary healthcare costs, radiation exposure, and the logistical burden on elderly patients. These findings help identifying the routine X-ray follow-up as a possible low-value intervention that could be safely omitted. Trial Registration: ClinicalTrials.gov Identifier: NCT04651543. 2022/04/08 </p>