Shoulder Fracture Fixation

Fixation of Proximal Humerus, Clavicle, Scapula and Glenoid fractures

Indications:          

• Proximal Humeral Fractures
• Clavicle fractures 
• Scapula / 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

	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 (guide to commence activity)
Return to work	Sedentary job: as tolerated  Manual job: at least 3 months
Driving	approx. 6-8 weeks
Swimming	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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