For treatment & information (Manchester UK)

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Shoulder Fracture Fixation

Fixation of Proximal Humerus, Clavicle, Scapula and Glenoid fractures

Indications:          

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.

Day 1 - 3 weeks

  • Arm Immobiliser
  • Wrist/hand/finger exercises
  • Elbow flex/ext, pro/supination
  • Shoulder girdle exercises
  • Scapula setting exercises
  • Passive ROM in all directions as tolerated - Do not force or stretch

3-6 weeks:

  • Gentle isometric exercises in neutral as pain allows
  • Wean off sling
  • Begin active assisted exercises ensuring glenohumeral movement, not scapulothoracic - Do not force or stretch

6 weeks +:

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

 

Milestones

 

4 Weeks

50% pre op passive ROM

 

6 Weeks

Passive ROM equal to pre op level

Passive ROM 50% of pre op level

12 Weeks

Active ROM equal to pre op level

Passive ROM equal to pre op level

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


See Post-Operative Exercises
                                                     

Return to functional activities

Driving                        8 - 12 weeks

Swimming                   Breaststroke:   6 - 12 weeks

Golf                            3-6 Months

Lifting                         Light lifting can begin at 6 weeks.  Avoid lifting heavy items for 6 months.

Return to work          Sedentary job: 6 weeks

                                    Manual job:     Guided by Surgeon


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