Proximal Humerus Fracture — Non-Operative (Non-Displaced)

Ortho Illinois / Crystal Lake Orthopaedics · Dr. Rolando Izquierdo MD

Weight-Bearing

Sling at all times except exercises Phase I; wean per tolerance

Key Restrictions

Non-displaced defined as <1 cm displacement and <45 deg angulation; no extension or IR until 6 wks; no shoulder extension or IR isometrics until Phase II; bony healing typically 6-8 wks in adults; return to normal function/motion 3-4 months; hot packs 10 min before exercising starting wk 2; supine ER with stick to 30 deg supported on folded towel with shoulder at 15 deg ABD

Timeline & Phases

3 phases: Phase I Early Motion (0-5 wks — wk 1 supine PROM FF ≤90 + gentle ER; wk 2 pendulums + soft tissue mobs; wks 3-5 AAROM FF ≤140 + submaximal ER/flex isometrics wks 3-4), Phase II Active Motion (wks 6-12 — AROM wk 6, extension + IR begin wk 6, theraband wks 8-10), Phase III Aggressive Stretching/Strengthening (wk 12+)

Notes

Single surgeon protocol (Dr. Izquierdo); March 2014; explicit non-displaced definition (<1 cm, <45 deg); extension AND IR explicitly withheld x 6 wks; serratus punches introduced Phase II wk 6-8; UBE no resistance Phase II wk 8-10; prone extension and ABD Phase II; functional/sport activity begins Phase III; isotonic strengthening with weights all directions Phase III

Surgeon / Author

Dr. Rolando Izquierdo MD

Published

March 2014