Proximal Humerus Fracture — ORIF (Locking Plate)

Dr. Grant S. Garrigues MD (Rush University Medical Center) · Dr. Grant S. Garrigues MD

Weight-Bearing

Sling with abduction pillow at all times except exercises (3-5x/day), showering, and dressing; D/C at wk 6

Key Restrictions

Intraoperative safe zones established by surgeon (two programs): 140/40 Program (FF 140 + ER 40) or 130/30 Program (FF 130 + ER 30); stay within surgeon-defined safe zone Phase I; no ABD; no aggressive or forced PROM until radiographic union; ROM before strengthening emphasized; biceps tenodesis co-procedure: no resisted elbow flexion x 6 wks, support well arm for elbow flexion/extension wks 1-2; no sudden forceful resisted IR (golf, swimming) until >3 months

Timeline & Phases

2 phases + return to activity: Phase I Passive Motion (0-6 wks, PROM within safe zone per surgeon: FF 140/130 + ER 40/30; pendulums; scapular retraction; active elbow/wrist/hand AROM; ice 20-30 min as much as possible first 8-10 days), Phase II Active ROM (6-10 wks, full ROM by wk 10 if radiographic healing; begin AROM/AAROM; side-lying ER; Theraband 2 lbs after passive motion restored; scapulothoracic strengthening; aquatic therapy earliest 1 month if wound healed), Return to Activity Phase (wks 10+, sports/occupation specific)

Notes

Single-surgeon protocol; two distinct intraoperative safe zone programs (140/40 vs 130/30); radiographic healing required before advancing Phase II; full ROM goal by wk 10; sleeper stretch and hand slide IR at wk 6; prone T scapular strengthening; aquatic PT at 1 month minimum; October 2018

Surgeon / Author

Dr. Grant S. Garrigues MD

Published

October 2018