Proximal Humerus Fracture — ORIF

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling at least 3 wks (remove 4x/day for exercises and ADLs); wean at wk 4; no driving until adequate ROM, sling D/C, off narcotics

Key Restrictions

No ABD >90 deg Phase I; ER 0-40 deg Phase I; no lifting >1 lb Phase I; no lifting >2 lbs before 6 wks; no forceful end-range overpressure; no isotonic shoulder strengthening Phase II; no motions into painful ranges; bone health, blood supply, pre-op ROM/strength all affect progression — communicate with surgeon

Timeline & Phases

4 phases: Phase I (wks 1-4, PROM: FF 140, ER 40, ABD 90; pendulums; scap retraction), Phase II (wks 4-8, AAROM then AROM at wk 6; lawn chair/table slides/pulleys; shoulder isometrics; biceps/triceps/prone rows), Phase III (wks 8-12, AROM, progressive strengthening — RTC, deltoid, periscapular), Phase IV (wks 12+, return to function/sport)

Notes

Criterion-based; PROM goals to progress: FF 140 + ER 40 + ABD 90 by wk 4; AROM starts at 6 wks explicitly; biceps tenodesis co-procedure: avoid resistance elbow flexion x 6 wks; factors affecting outcomes noted: bone health, blood supply, BMI, smoking, diabetes; complications to monitor: fever, numbness, drainage, pain. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2026-02-28.]

Surgeon / Author

MGH Sports Medicine