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Fracture Shoulder Replacement

Indications:

• Severe fractures of the humeral head and neck, that is not reconstructable.

The main aim of the procedure is to reconstruct the tuberosities and rotator cuff around the prosthesis. The immobilisation is to protect this repair. To see the repair technique Click Here . 

This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase.

Pre-op

• ROM Exercises
• Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers.

Day 1 - 3 weeks

• Occupational Therapy
• Mastersling with body belt
• Wrist/hand/finger exercises
• Elbow flex/ext, pro/supination
• Shoulder girdle exercises
• Scapula setting exercises
• Pendular exercises
• Passive ROM in all directions as tolerated
• (Level 1 Exercises)
• (Level 1 Exercises)

3-6 weeks:

• Do not force or stretch
• Gentle isometric exercises in neutral as pain allows
• Wean off sling
• Begin active assisted exercises ensuring glenohumeral movement, not scapulothoracic.
• (Level 2 Exercises)

 Any acute loss of active movement should be referred to the next fracture or shoulder clinic     

6 weeks +:

• Begin active assisted exercises
• Progress to full active exercises in all ranges
• Begin rotator cuff strengthening (pain free)
• Closed chain exercise
• Begin stretching the capsule
• Begin proprioceptive exercises
• (Level 3 Exercises) 
• (Level 3 Exercises) 

Return to functional activities

Driving                        6 Weeks

 Swimming                   Breaststroke:   6 weeks

                                    Freestyle:          3 months

 Golf                             3 Months

 Lifting                         3 Months (Then guided by the strength of the individual patient)

 Return to work            Sedentary job: 3 weeks  

                                    Manual job:      Guided by Surgeon

For more information please contact therapists@shoulderdoc.co.uk

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If you are interested in making an appointment to discuss a treatment,
please click here to contact us, or telephone 0161 227 0027.