Shoulder Fracture Fixation

Fixation of Proximal Humerus, Clavicle, Scapula and Glenoid fractures


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




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 (guide to commence activity)
Return to work

Sedentary job: as tolerated 
Manual job: at least 3 months

Driving approx. 6-8 weeks

Breaststroke: from 6 weeks 
Freestyle: 12 weeks

Golf can start from 3-6 Months
Lifting Light lifting can begin at 3 weeks. 
Avoid lifting heavy items for 3 months.
Contact Sport E.g. Horse riding, football, martial arts, racket sports and rock climbing: after 3 months


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