Proximal Humerus Fracture — Proximal Humerus / Greater Tuberosity ORIF

The Iowa Clinic Orthopaedics · Dr. Christopher Kim MD

Weight-Bearing

Sling worn only as desired (not mandated for daytime); gentle passive pendulums immediately; no active shoulder motion x 4 wks

Key Restrictions

No active shoulder motion x 4 wks; gentle passive shoulder motion all planes without restrictions from day 1 (no ROM limits stated unlike other protocols); no cuff strengthening until active ROM full (3-6 months); scapulohumeral kinematics normalization emphasized throughout

Timeline & Phases

4 phases: Phase I 0-6 wks (2x/wk PT + daily home HEP 5x/day; sling worn as desired; PROM no restrictions; AROM neck/elbow/wrist/hand; pendulums 3x/day; icing 3-5x/day), Phase II 6 wks-3 months (2-3x/wk PT; PROM/AAROM all planes; periscapular strength; progress to AROM; isometrics when active ROM adequate), Phase III 3-6 months (1-2x/wk PT; RTC strengthening bands/dumbbells when full AROM achieved), Phase IV 6-9 months (4-5x/wk HEP; high rep/low weight full UE + RTC + periscapular strengthening)

Notes

Covers proximal humerus AND greater tuberosity ORIF; notable: most permissive protocol — no ROM restrictions for PROM, sling worn only as desired; discharge criteria: maximize ROM + full ADLs + normal scapulohumeral rhythm >100 deg elevation + independent HEP; longer overall timeline (9 months); periscapular strength emphasized equally with RTC throughout

Surgeon / Author

Dr. Christopher Kim MD