Exam (elaborations)
UE FRACTURES EXAM STUDY GUIDE
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UE FRACTURES EXAM STUDY GUIDE...
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REHABILITATION FOR NON-OPERATIVE HUMERAL FRACTURES /Early Passive Motion: (7-10 days post-fracture)
Goals: Control pain and oedema
Protect fracture site
Minimize deconditioning
Maintain range in joints around the affected region (wrist, hand, and
neck)
Prevent glenohumeral adhesive capsulitis and muscle flexibility deficits
Intervention:
• Modalities, such as TENS and ice, for pain control
• Splint/Sling as direct by MD
• Monitor use and weight-bearing instructions per MD
• Cardiovascular conditioning
• Gentle range of motion exercises of the neck, wrist, and hand
• Pendulum exercises
• Passive forward elevation of the shoulder
• Passive external rotation of the shoulder
NON-OPERATIVE HUMERAL FRACTURES / Early Passive Motion: (10
days to 3 weeks post fracture) When pain has diminished and the
patient is less apprehensive.
Goals: Same as above
Intervention: in addition to above
• Active assistive forward elevation
• Active assistive external rotation to 40°
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NON-OPERATIVE HUMERAL FRACTURES / Phase I: (3-6 weeks post
fracture)
Goals:
Continue to control pain and edema as needed
Minimize deconditioning
Regain full range of motion
,Prevent muscle atrophy
Intervention:
• Pendulum
• Active assistive forward elevation
• Active assistive external rotation
• Isometrics: Internal and external rotation, flexion, extension, and
abduction in a neutral
position (at 4 weeks)
• Active assistive hyper extension (at 6 weeks)
• Gripping exercises
NON-OPERATIVE HUMERAL FRACTURES / Phase II: (6-8 weeks post
fracture)
Goals:
Regain full Range of motion
Actively work within newly gained range of motion
Increase strength
Intervention:
• Active forward elevation in supine
• Active forward elevation with weights in supine
• Forward elevation in standing with stick
• Pulleys with eccentric lowering of involved arm
NON-OPERATIVE HUMERAL FRACTURES / Phase III: (8 weeks post
fracture)
Goals:
Increase strength (especially at end range)
Gain adequate strength in the rotator cuff to allow for humeral head
depression necessary to avoid impingement
Strengthen scapular rotators to allow for proper scapulohumeral rhythm
Intervention:
• Resistive exercises: standing forward press, theraband resisted
(flexion, internal rotation, external rotation and abduction) exercises, and
rowing
• Self stretching: flexion/abduction combined, internal rotation, flexion,
abduction/external rotation combined, bilateral hanging stretches
, • Advanced internal rotation, shoulder flexion, external rotation and
horizontal abduction stretching
REHABILITATION FOR ORIF AND HUMERAL HEAD
REPLACEMENT/pre-op
• Injury is protected with immobilization through casting, splinting and/or
placed in a sling
• Patient is instructed of post-operative rehabilitation goals and plan
ORIF AND HHR/Early Passive Motion: (3-5 days post op)
Goals: Control pain and edema
Protect fracture site
Minimize cardiovascular deconditioning
Maintain range in joints around the effected region (wrist, hand, and
neck)
Prevent glenohumeral adhesive capsulitis and muscle flexibility deficits
Intervention:
• Modalities, such as TENS and ice, for pain control
• Splint/Sling as direct by MD
• Monitor use and weight bearing instructions per MD
• Cardiovascular conditioning
• Gentle range of motion exercises of the neck, wrist, and hand
• Passive supine external rotation to 40°
• Passive supine forward elevation
ORIF AND HHR- Phase Ia: (7-10 days post op) and Phase Ib: (3 weeks
post op)
Goals:
Continue to control pain and edema as needed
Minimize deconditioning
Regain full range of motion Prevent muscle atrophy
Intervention: Phase Ia
• Pendulum
• Passive external rotation with stick or pulleys
• Passive forward elevation with assist from non involved arm or pulleys
• Passive internal rotation and hyperextension with stick (not to be done
with tuberosity fracture)
• Cardiovascular conditioning
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