Proximal Humerus Fracture — ORIF

Mammoth Orthopedic Institute / Sierra Park PT · Dr. Timothy Crall MD (US Ski Team Physician); Bartlett White PA-C

Weight-Bearing

Sling at all times or per MD; no AROM, lifting, pushing, pulling x 6 wks; D/C sling per MD based on X-ray

Key Restrictions

No AROM/lifting/pushing/pulling x 6 wks; no ER >40 deg or excessive extension x 6 wks; no supporting body weight; X-ray evidence of healing required to progress all phases; no overhead lifting until 4-6 months; no IR/ER Phase II; 20 lb weight limit Phase III; no overhead activity Phase III

Timeline & Phases

4 phases: Phase I (wks 1-3, PT 2x/wk starting wk 1; PROM FF 90 + ER 30; scapular clocks; pendulums; incision mob; stationary bike in sling), Phase II (wks 3-6, AAROM FF 90 + ER 40; pulleys; grade I-II GH mobs; pool at wk 3), Phase III (wks 6-12, full PROM/AAROM/AROM; submaximal RTC isometrics wk 6; isotonic RTC wk 8; grade III-IV mobs wk 8; general UE strength wk 10), Phase IV (wk 12+, full ROM; no overhead lifting until 4-6 months; sport-specific when AROM bilateral + strength 4+/5)

Notes

US Ski Team physician; PT starts wk 1 (earliest of all protocols here); X-ray progression criterion throughout; pool at wk 3; pec minor stretching Phase III for scapular protraction; posterior scapular stretching wk 8 if needed; return to work/sport: bilateral AROM + 4+/5 strength

Surgeon / Author

Dr. Timothy Crall MD (US Ski Team Physician); Bartlett White PA-C