Proximal Humerus Fracture — Humeral Fracture ORIF (Proximal, Mid-Shaft, or Distal)

Ellis & Badenhausen Orthopaedics (Louisville, KY) · Dr. Sean M. Griffin MD

Weight-Bearing

Sling full time x 2 wks; outside home only wks 2-6; D/C at wk 6; sleep arm out of sling on elevated pillows for edema

Key Restrictions

No aggressive or forced PROM until X-rays show full union; no IR behind back or horizontal adduction; no lifting >1-2 lbs; no ABD — wall walking and table slides only for flexion/ABD; no anterior or inferior GH mobs wks 6-9; no overhead lifting until 4-6 months; strengthening only if overall pain level is low; covers proximal, mid-shaft, AND distal humerus ORIF

Timeline & Phases

4 time frames: Wks 1-4 (sling, PROM FF/ABD 90 + ER as tolerated; scap shrugs/retraction; wall walking/table slides; ice/modalities), Wks 4-6 (D/C sling at wk 6; ROM all planes as tolerated; serratus exercise wks 5-6; no-load ER/IR with towel roll; submaximal isometrics), Wks 6-9 (posterior capsule stretches; UBE; scapular strength; Theraband IR/ER/flex/ABD; rows no beyond plane of body; CKC: quadruped → ball compression → wall push-ups; rhythmic stabilization wks 9-12 at 110-120 flex), 3-6 months (advance RTC/scapular/UE strength; no overhead lifting until 4-6 months)

Notes

July 2022; unique: covers proximal AND mid-shaft AND distal humerus ORIF in one protocol; sleep with arm out of sling on elevated pillows for edema control; serratus exercise at wks 5-6; no anterior/inferior GH mobilization wks 6-9; kinesthetic awareness supine exercise in ER/IR wks 6-9; CKC progression (quadruped → ball compression → wall push-ups → perturbations); 10 physicians listed

Surgeon / Author

Dr. Sean M. Griffin MD

Published

July 2022