Clavicle Fracture ORIF

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling at least 3 wks, removed at least 4x/day for exercises and ADLs; sling while sleeping until 6 wks; wean from sling during the day and discharge completely at 6 wks; no weight bearing through involved arm Phase I

Key Restrictions

Phase I (1-4 wks): no active shoulder motion, no lifting or carrying with involved arm, no weight bearing through arm, no flexion or abduction beyond 90 deg; Phase II (5-8 wks): no lifting heavier than a coffee cup, no forceful stretching or painful positions; Phase III (9-12 wks): no lifting >5 lbs; swimming and running only if cleared by surgeon; contact surgeon for fever, unresolving numbness/tingling, excessive drainage or uncontrolled pain

Timeline & Phases

5 phases: Phase I (1-4 wks, PROM: ER/IR in scapular plane to tolerance, flexion/scaption/ABD <=90 deg, pendulums, table slides; elbow/wrist/hand resisted work from wk 2), Phase II (5-8 wks, wean sling, full PROM, AAROM and AROM, periscapular and elbow strengthening, stationary bike after 6 wks), Phase III (9-12 wks, maximize AROM, stretching, rotator cuff isometrics and resisted IR/ER), Phase IV (12-16 wks, isotonic shoulder strengthening, wall push-ups, return to normal ADLs), Phase V (4-6 months, push-up progression, interval return to sport; 90% strength on dynamometry and 0% QuickDASH disability)

Notes

Time and criterion based; factors affecting progression: bone health, blood supply, pre-op ROM, age, BMI, smoking, diabetes; criteria to progress each phase listed (e.g., 90 deg PROM flexion and 30 deg ER to leave Phase I, 120 deg AAROM flexion to leave Phase II); revised 1/2023; references included

Surgeon / Author

MGH Sports Medicine

Published

January 2023