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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

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) 

 

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

 


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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