Due to their limited movement following a proximal humerus fracture, individuals lose their range of shoulder motion and may develop stiffness of the shoulder joint. endstream endobj 111 0 obj <. ;XzGfwS0 iI}_Gdx,54VEanC>N[3QHX;T %} f@rw%.aEbq X> jN8_ p Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury. Exercises: Start these exercises straight away. table slides, wall climbs, supine wand exercises in all planes . do not line up normally. The fracture can happen due to a direct injury or assault on the arm. Shoulder adduction abduction. Surgery usually involves internal fixation of the fragments with plates, screws or a nail. Fracture Blisters. shoulder and the elbow. Menu. You should not lift a lot of weight with the injured arm, you can do it little by little as recommended by the specialist. However, we will do our best to deliver the best evidence-based-practice therapy that we can deliver (we try our best to only engage the most experienced and specialist therapists - which makes a big difference in clinical outcomes). exercises and daily activities such as eating, dressing, and bathing . and both the shoulder She had such a good session Meg had asked whether she can come back for another session!!!! There may be damage (or risk of damage) to the brachial artery. X-rays will be taken in different directions, usually from. Swing your arm slowly and gently forwards and backwards. endobj Repeat 10-15 times provided there is no increase in symptoms. Rehabilitation involves gradually increasing activities to restore muscle strength, joint motion and flexibility. The most common site of fracture is at the junction of proximal 1/3rd and distal 2/3rd. Hold for two to three seconds; then slowly sit back up. damage: A displaced humeral fracture happens when the fractured humeral bone fragments of the shaft Treatment varies depending on the type and severity of the break but may include the use of a sling, brace, splint or cast and/or surgery. Healing of a mid-shaft humerus fracture with non-surgical treatment generally takes ten to twelve weeks. It is important to receive physical therapy after your humerus starts to heal. Grip strength exercise. Consult your surgeon before exercising after a humerus fracture to be sure these exercises are safe for you. The initial management following a fractured shaft of the humerus should be undertaken at an accident and emergency department. The two complications often seen are injuries to the radial nerve and nonunion of the fracture. Notify me of follow-up comments by email. Phase-3: Week 6 to 10. The stable fracture can be managed conservatively but the un-stable fracture needs surgical intervention. <> Repeat 10 times, working up to three sets in a row. Motion: Full motion by 8 weeks. Traditionally, humeral shaft fractures have been described according to the following features: Location - Proximal, middle, or distal. The mid-shaft of the fibula was harvested and shaped to fit the medullary canal. Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). to support and move the broken arm. The most common cause of a humeral shaft fracture is a fall, but high-energy injuries (motor vehicle collisions, sports injuries) and penetrating trauma (gunshot wounds) also can cause this injury. In extreme cases it can stop healing altogether. bone). Squeeze the ball as hard as possible without pain. Application . Pendulum exercises Neck ROM exercises Elbow, wrist, and hand ROM exercises Scapular exercises - shrugs, squeezes, and PNF Passive shoulder ROM exercises in supine Pulleys Modalities for pain and swelling _____ Phase II (AROM): Weeks 4-6. This process is typically known oblique or transverse fracture patterns that may displace with a. hanging arm cast. J Am Acad Orthop Surg. Initial exercises to do 4-5 times a day: Finger and wrist flexion and extension Open and close your hand as shown 10-15 times. Mid-shaft If this is not the case please let us know using the contact details. A fracture in this area can be very painful and make elbow motion difficult or impossible. Strengthening exercises can begin as early as three weeks after injury, depending on its severity. Verywell Health's content is for informational and educational purposes only. Physical Therapy Prescription Humerus Fracture ORIF Patient Name: Today's Date: Surgery Date: Diagnosis: s/p ( LEFT / RIGHT ) HUMERAL SHAFT FRACTURE ORIF RECOVERY / RECUPERATION PHASE: WEEKS 0-6 __ Restore full ROM __ Modalities, Cryocuff / Ice, prn . Hey, do note that it is very, very important to stick with the shoulder physiotherapy program with us and to do your *If surgery was not performed, PROM should not start until 3 weeks from the date of injury. Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. Open and close your hand as shown 10-15 times. Turn your body until your non-injured side is next to the door where the band is secured. Rehabilitation plan 0 - 1 fracture clinic appointment Wear the brace & sling all of the time, even in bed at night. Interestingly, one of the most common reasons for nonunion is surgery . Youre in good hands with decades of Read our, Proximal, Mid-Shaft, and Distal Humerus Fractures. In some cases a Sports and deep tissue release massage helps to increase nutrient-rich blood Twitter; Facebook; LinkedIn; Contact. Slowly lower back down. Hold the position for 20-30 seconds and repeat 5 times provided there is no increase in symptoms. Management depends upon whether the fracture is stable or unstable. 0 affect. Or, if you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter. Strengthening: Progress to higher weights. Fractures of the humerus are divided into three types: A mid-shaft humerus fracture represents about 3% of all broken bones. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. [3] Rehabilitation after initial conservative treatment Aim: Restoring range of motion and normal shoulder strength and ultimately function [3] Gently move your shoulder following the exercises shown. PHASE I: IMMOBILIZATION . But to better understand the concept of fracture we first need to understand its related anatomy. . We treat you like our family, so we will want only the best for youie, full 100% recovery, and nothing short of that. Proximal humerus fracture rates will continue to increase with the aging population 5-7,58 and the concomitant rise in osteoporosis. Isometric exercises are the most basic form of strengthening after a humerus fracture. Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting. Disclaimer: Phoenix Rehab is group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical Pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. Mid-shaft even though healing may not be completely straight, Having regular deep tissue and sports massage. Please note that all fields followed by an asterisk must be filled in. The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy, TCM, podiatry, BodyTalk, CranioSacral Therapy, SomatoEmotional Release etc, please schedule an appointment with us by contacting us. Humerus Mid-Shaft Fracture: s/p Open Treatment with Internal Fixation Post-Operative Rehabilitation Protocol . 2014;37(3):e307e312. Your hand should be supported higher than your elbow. If you break your humerus, you might need surgery to repair your bone. My name is Nigel Chua, I'm the CEO and a principal hand therapist by training; my wife is Louise, she's the founder-COO and principal physiotherapist of Phoenix Rehab - and we're here to serve you. A mid-shaft humerus fracture is a type of broken arm. endstream endobj startxref 25 This will increase the demands on health providers further, and some suggest that society faces an epidemic of fractures in the elderly . After a few days, hold a soft ball/ball of socks. degrees flexion. muscles from scar tissue micro-tears (and potential ruptures), and increases muscle Our senior allied health practitioners (physiotherapists, occupational therapists) are registered, regulated and accredited by the Allied Health Professions Council (AHPC), an arm of Singapore's Ministry of Health (MOH). Start the "Initial Exercises" below straight away. of humeral shaft fractures with minimal shortening and for short. It is cylindrical in shape with slightly flat on the proximal (upper) part and conical on the distal (lower) part. However, once they become easy you can start with the posture and pendulum exercises. Management of humeral shaft fractures. Because each and every pain case is unique, we advise to consult your doctor before applying tips given here. and, elderly females (60-70s) with low-energy or low-impact type of injuries. The splint is heavily padded. location and severity of the fracture, but good news is that in most cases, surgery is not 150 0 obj <>stream Humeral shaft fractures are common injuries, accounting. stream realigning the bones too. Details regarding the patient demographics and fracture pattern were recorded. Humerus fracture recovery exercises typically begin with activities to improve shoulder movement, three weeks after injury, according to rehabilitation guidelines recommended by Mammoth Orthopedic Institute. Hold for two to three seconds and then walk them back down. A broken arm is a common injury and is usually a consequence of a fall with an outstretched hand, a car crash or some other type of accident. Greater Tubercle NOT greater trochanterMedial and Lateral Epicondyle NOT malleoliTrochlea NOT condylar, Your email address will not be published. __ Trunk exercises for sport specific activities (i.e. Sometimes this fracture gets associates with radial nerve injury resulting inwrist drop. Whichever part of the bone is broken, a midshaft humerus fracture will typically cause: Sometimes, midshaft humeral fractures can be very obvious especially when there is obvious fracture deformity. Stuart Hershman, MD, is board-certified in orthopaedic surgery. Repeat 10 times. After just a few weeks we Clavicle Fracture Treatment: When Is Surgery Necessary? Johns Hopkins Medicine. of the upper arm. The techniques presented can be used by clinicians to create treatment plans, achievable functional goals, and realistic expectations for their clients. humeral fractures, however, which are also known as. PHASE IV: RETURN TO FUNCTION . Twice daily is recommended. support the arm. will be able to progress you with progressive strengthening exercises There are a few techniques used to repair comminuted fractures, and which one your surgeon uses will depend on your injuries, which bone is fractured and any other complications after your trauma. patients may not regain full 100% shoulder movement, but they usually regain Having regular deep tissue and sports massagewill keep your muscles healthy and fit with body/movement-confidence. you have an open fracture you will be given additional antibiotics to So, this shoulder elevation exercise is a very simple, basic exercise. The back surface of - Rotational alignment of humerus after closed locked nailing. Bend and straighten your elbow so you feel a mild to moderate stretch. Humerus Fracture (Upper Arm Fracture). However in many of them, the attending doctor will need to confirm these fractures with imaging. Love the vibe of Phoenix Rehab! Ayotunde OA, Sunday OK, Oluwatoyin A, Dare OJ. It also includes the hinge of the elbow joint on the bottom. The treatment centre you attended will have provided you with a type of sling called a "collar and cuff". If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice. All the exercises we are going to cover is aimed at strengthening the muscle of the arm, forearm and regain the range of motion of the elbow, wrist, shoulder joint. This might happen in the part of the humerus near your shoulder, near the middle of the humerus, or in the part of the humerus near your elbow. This information will guide you through the next 6 weeks of your rehabilitation. Dowel exercises allow your uninjured shoulder to assist movement of your injured arm. At the first session, our specialist physiotherapists will carry out a thorough Distal humerus fractures are where the humerus bone is broken the furthest away, nearer the elbow. bone. Keep it on for your exercises. The shaft can break near the top of the bone, in the middle, or near the bottom of the bone. This helps to stabilise your broken bone and allows you to move your elbow gently to avoid that getting stiff while your fracture heals. Hold your injured wrist with your opposite hand. In one of our posts 3 Fracture Humerus Classification, Its Sub-Type Simplified we have seen that our arm can get fracture at three different sites. This fracture is commonly seen in adults but in rare cases, it may also happen to children. For this exercise, our starting position would be similar to the previous exercise. In this extended elbow position, put slight overpressure with the opposite hand till you feel a comfortable stretch on the front of the elbow. Follow up sessions are inline to provide Regular painkillers will be required during your healing stage to aid recovery. Developed by Brighton & Sussex University Hospital Trust. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. Stand and lean forward supporting yourself with your other hand. For this exercise our starting position would be quite different, this time stabilize the forearm by keeping it flat on the table as in the figure. You can do this exercise freely without holding anything, but as you progress with the exercise I recommend you to hold a cane or a lightweight rod and then move the forearm in both directions. 3 0 obj This is a very painful injury due to muscle spasms and the bone ends moving. Injury to the Read more patient praise and testimonials here, 9 Tampines Grande #01-20 Singapore 528735 | CONTACT, passionate about what we do (I've been practicing since 2005; and Louise since 2006), and here in Phoenix Rehab - we have cherry-picked the best and most experienced team of principal-grade, physiotherapists, hand therapists, TCM Allow your injured arm to dangle as you bend forward at your hips until your back is parallel to the ground. Mid-shaft humerus fractures may be treated with: 1. So strengthening the grip is also very important and it is also important to carry on with other coming exercises. The two complications usually encountered are injuries to the radial nerve and nonunion of the fracture. Home; Follow. stiffness and weakness from developing and it is usually fine to take 3 0 obj As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth, but you can also make an appointment without seeing any doctors (that being said, if you do need a referral to a specialist orthopedic surgeon or sports GP, we will recommend you too as value added service at no additional costs to you). In a shaft of humerus fracture case, immediately after the removal of plaster cast the most important secondary complication is elbow joint stiffness. Nonunion can happen for a number of reasons. If the upper arm bone (humerus) fractures into two or more pieces, the jagged ends can injure nearby nerves and blood vessels. This article focuses on midshaft humerus fractures. Hold for 5 seconds and repeat 10 times. &DCv: bY_^pvryiy8Y+Il DVPY::DA9*h8aDv[|B *kWH\}s`l~fr}>Q: B-"}jq2 You'll need physical therapy to regain your ability to move your arm. Shoulder stiffness can become problematic if not taken care of. Exercises for Increased Shoulder Flexibility, Deutsches Arzteblatt International: "The Treatment of Proximal Humeral Fracture in Adults", American Physical Therapy Association: "Physical Therapist's Guide to Proximal Humerus Fractures", Geriatric Orthopaedic Surgery & Rehabilitation: "Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient", Mammoth Orthopedic Institute: "Rehabilitation Guidelines for Proximal Humerus Fracture (Non-Operative)". Kings Drive, Eastbourne, East Sussex, BN21 2UD See our entire team here with introductions and their specializations. move the arm, and active assisted exercises where you use your good arm In this starting position straighten the elbow as much as it could, this is termed as an extension of the elbow. depending on the location and direction of the break and the associated Top Exercises & Stretches After Healed Shoulder Fracture (Humerus, Scapula, or Clavicle) Bob & Brad 4.63M subscribers Subscribe 3.4K Share 199K views 4 years ago "Famous" Physical Therapists Bob. The rehabilitation differs slightly from nonoperative treatment, with no splints or cast. Masks are required inside all of our care facilities. However, other factors are also considered when deciding between surgical fixation or nonoperative treatment. We had a great session at Phoenix Rehab! 2 0 obj But it is also common among sedentary individuals, Tendonitis, tendinopathy and tendinosis are all tendon injuries and treated by physiotherapists and hand therapists, Cervical spondylosis is a general term to describe the degenerative condition in the neck which results in pain and other symptoms, Tendinopathy (tendon injuries) can develop in any tendon of the body and has many names such as tendinitis and it can be treated with good tendon physiotherapy. Mid-shaft humeral fractures should be followed up in fracture clinic at 1 week. shoulder exercises every day until you have regained full. Hold two to three seconds and then slowly return to the starting position. 2013 Jul;7(3):105-9. doi: 10.4103/0973-6042.118911. - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. Learn how to conduct effective rehabilitation exercises to heal a radial head fracture elbow. Slowly bend forward, sliding your forearm along the table until you feel a gentle stretch in your injured shoulder.