This is a very common fracture that occurs in people of all ages. Olecranon Fracture Rehab Protocol. As a result, diagnosis and treatment of scapular injuries may be delayed or suboptimal. Indicated for non-op treatment or ORIF. About. Scapula. brachial plexus injury. Nonoperative Treatment of Proximal Humerus Fracture Rehabilitation Considerations o Usually nonoperative care is selected for those patients O thopae ic institute of Ohio Samir Patel, who are medically unfit for surgery or have a minimally to nondisplaced fracture o Depending on the severity of the fracture the best outcome may Scaphoid fractures are much more common in adolescents than younger children. The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulders range of motion. rib fracture. NWB. Rehabilitation Protocol for Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF) Scapular retraction and mobility exercises Criteria to Progress displaced proximal humerus fractures in the elderly: A prospective study. May begin scapular retraction and depression *Sling Arm in sling at all times for 2 weeks except for exercises and bathing (includes nighttime) Other Continue Cryotherapy Incision mobilization and desensitization Modalities to decrease pain and inflammation !1 Shoulder Fracture ORIF: Postoperative Protocol The scapula connects to the clavicle (collar bone) in the front of the body, and to the humerus (arm bone) at the side. Shoulder Fracture Fixation. "Effect of two rehabilitation protocols on range of motion and healing rates after arthroscopic rotator cuff repair: aggressive versus limited early passive exercises." ! Lie on your back or sit upright in a chair with your arms in front of you relaxed on your thighs. Ice. Townsend H, Jobe FW, Pink M, Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. Begin gentle passive ROM above shoulder level. Rowe 90, 91 reported that 71% of the patients in his series of scapular fractures AAROM>AROM as tolerated; PROM Goals: FF 120, ER 50, IR 50, Active FF 100. Apply cold packs to the shoulder 20 minutes each hour to reduce pain and swelling. Most fractures of the scapula can be treated without surgery. pneumothorax and/or pulmonary contusion. 1lb limit. You have sustained a fracture to your scapula (shoulder blade). As stated, high speed automobile accidents, blunt trauma, or significant fall are some of the causes of a Scapula Fracture or Broken Shoulder Blade. Int J Shoulder Surg. Repeat 12 -15 times . The Scaphoid bone is one of 8 carpal bones in the wrist. Cervical ROM as needed to maintain full mobility. Scapula. C-spine AROM. American Journal of Sports Medicine. Treatment involves immobilization with a sling or a shoulder immobilizer, icing and pain medications. Strengthening: Begin gentle isometric exercises at four weeks. Proximal Humerus Fracture Repair and Rehabilitation. Non-Operative Proximal Humeral Fracture Rehabilitation Protocol General Principles: 1. Used for sleeping only for weeks 6-8. Passive ROM: flexion and abduction to 90, ER as tolerated with elbow at side, IR to 45 with elbow away from side in supine Used for sleeping only for weeks 6-8. Rehabilitation Protocol: Post-Operative Cervical Spinal Fusion Department of Neurosurgery Lahey Hospital & Medical Center, Burlington 781-744-7580 Lahey Neurosurgery at Emerson Hospital 978-287-3194 scapular-thoracic re-education (shoulder shrugs, shoulder rolls, Indications: Proximal Humeral Fractures; Clavicle fractures ; Scapula / Glenoid fractures; This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase. Seated scapular retractions Week 3 4 AAROM and Isometrics 1. Depending on how severe the fracture is, you might need to start exercises within a week after the injury, while others require two to four weeks before beginning the exercises. Three times a day. The SHOULDER ANATOMY External Rotation Attach theraband to a stable object at waist level Roll shoulders back and down and maintain this position . Early rehabilitation should aim to improve the endurance and strength of the scapular stabilizing muscles. Most commonly the body of the scapula is involved and nonoperative management remains the mainstay of treatment for these fractures [].As these patients are usually high-demand young adults, it is important to ensure treatment will have a Scapular retraction Office Visit Call 617-726-7500 to reach your doctor; 617-643-9999 to reach MGH Sports Physical Therapy. Start the "Initial Exercises" straight away, ideally within the first 72 hours. The Orthopaedic and Fracture Clinic 1431 Premier Drive Mankato, MN 56001 507-386-6600 Dr. Allen Olecranon Fracture Repair Rehabilitation Protocol Phase I: Protection (Weeks 0-6) Weeks 0-2 -First post-op visit at ~2 weeks -Leave splint in place until first visit (bag on arm to shower) -Arm will be splinted at 90 for the first 2 weeks A scapula fracture is an uncommon injury. Whats Causing Unstable Shoulders?Use it or lose it! The sad truth is, most of us dont learn how to control or use our scapulae properly. Posture. Surprise, surprise! Overtraining. Overtraining certain exercises, although likely done in an attempt to stay fit, can actually contribute to shoulder instability.Misinformation. It is also recommended to consult the operative report for further information on the surgical procedure. Remove the sling several times a day. This normally takes between 6-12 weeks to unite (heal). Begin active motion in plane of scapula, AAROM pulleys, sub-max pain-free isometrics in neutral, scapular Sub-maximal isometrics. Fractures of the scapula are rare and usually associated with high-energy trauma. Bend and a treatment protocol for classification for me and It is the most common fracture of childhood. Moseley JB, Jobe FW, Pink M, Perry J, Tibone J. EMG analysis of the scapular muscles during a shoulder rehabilitation program. PHASE III Weeks 7-9 Initiate isotonic exercises starting with therabands and progressing to weights after week 8 Upper extremity PNF Concentrate on RTC and scapular strength. Begin pendulum (Codman) exercises 3. FRACTURES JOINT REPLACEMENT SPORTS MEDICINE CLAVICLE FRACTURE ORIF PROTOCOL (Dr. Sean Griffin) Weeks 1-3 Full time in sling Avoid IR behind the back, lifting more than 1-2 lbs, and horizontal adduction. The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. Expect to spend six months to one year recovering from 4. Positioning full time in sling with abduction pillow. Many muscles elicited by the arm will talk with me. A 53-year-old-man with decreased left shoulder strength resulting from a 9-week period of inactivity following his surgery received physical therapy Call Main Office for.. General Questions Schedule an Appointment. Complete LSSS failure, Floating shoulder, Ligament repair 3. This step-by-step guide is similar to a shoulder program your PT may use during your rehab to help you get control of your scapula. Adam Seidl, MD Highlands Ranch Hospital Assistant Professor (720) 516-4090 Shoulder/Elbow Surgery Inverness Department of Orthopedics (303) 694-3333 University of Colorado Anschutz Medical Campus (720) 848-1900 Rehabilitation Protocol Scapula (Shoulder Blade) Fractures. Educate patient to mobilize neighboring joints immediately (elbow, forearm, hand) Prevent shoulder stiffness with exercises (10x each set, repeat 4-5x/day) for: Shoulder retraction. Educate patient to mobilize neighboring joints immediately (elbow, forearm, hand) Prevent shoulder stiffness with exercises (10x each set, repeat 4-5x/day) for: Shoulder retraction. 1) An exercise bar, which lets the patient use the uninjured left shoulder to passively move the affected right side. Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. The clavicle lies A fall onto the lateral shoulder most frequently causes a clavicle fracture. Bending over to perform pendulum exercises is recommended 3 Summary. Plaster to immobilise elbow until wound review. ! Furthermore, the literature is controversial regarding surgical indications and rationale for treatment. The associated injuries may be multiple and/or life-threatening. Rehabilitation Protocol Humeral Shaft Fracture (ORIF) PHASE I: Protected ROM (6 weeks) Keep dressing in place, you may shower directly over clear plastic. PHASE ONE: 0 4 Weeks Post-Injury Program GOALS: 1. AAROM>AROM as tolerated; PROM Goals: FF 120, ER 50, IR 50, Active FF 100. Appointments Continue physical therapy 1-2 x/week Rehabilitation Goals Increase RTC strength Restore scapula-humeral rhythm Precautions None Suggested Therapeutic Exercises Posterior capsule stretching if indicated Isotonic exercises for RTC, scapular muscles PNF Theraband rows, ER, IR, shoulder extension Clavicle fractures are very common injuries in adults (25%) and children (1015%) and represent the 4466% of all shoulder fractures. A scapula fracture is an uncommon condition (accounting for approximately 1% of all fractures) and is characterized by a break in the shoulder blade (scapula) (figure 1). Phase I (0 to 7 days) Hand and Finger ROM. Pain medication, including acetaminophen, can help relieve pain as the fracture heals. Please use this protocol and the information below to guide this patients rehabilitation. Phase 2: Week 2-6. Use sling except with hygiene and therapy ! Prognosis. This case report describes the physical therapy intervention for a patient with an open reduction and internal fixation of a scapula fracture with decreased shoulder strength, Description. Scapular fractures usually are sustained as the result of severe trauma. Scapula fractures are frequently the result of high-energy trauma thus there should always be concern for associated injuries and a complete physical exam should be performed. They are often caused by high energy blunt trauma such as a fall from height. Shoulder shrugs and retractions (no weight) ***Pain control modalities PRN. Low to moderate cardiovascular work. 175 Cambridge Street 2. Keeping your arm at your side, bend and straighten the elbow, flex the wrist, hand and fingers. Begin active-assisted ROM progressing to active ROM in all planes. Scapula Body Fracture ORIF..27 Humeral Shaft Fracture Non-Operative ..28 Humeral Shaft Fracture ORIF 29 Nonsurgical treatment with a shoulder immobilisation sling works best for most fractures of the scapula. Your diagnosis is: Scapula (shoulder blade) Fracture The scapula is the triangle shaped bone at the back of the shoulder. When available 196 data was pooled from nine studies that compared the rates of scapula spine fractures between 197 implant designs, the increase in the incidence of scapular spine fractures in the onlay group was 198 not statistically significant (p=0.09). The scapula, or shoulder blade, is the triangular-shaped bone on each side of your upper back. Scapula fractures have a high association with concomitant injuries. Early Management: The first 72 hours Treatment: The majority of fractures are treated non-operatively. Nonoperative Treatment of Proximal Humerus Fracture Rehabilitation Considerations o Usually nonoperative care is selected for those patients O thopae ic institute of Ohio Samir Patel, who are medically unfit for surgery or have a minimally to nondisplaced fracture o Depending on the severity of the fracture the best outcome may Rehabilitation Scapular Winging SC Joint Shoulder Arthroplasty Shoulder Instability ST ! Frequency: 1 set. 1lb limit. Protect Clavicle: Arm sling for 6 weeks 2. 2. Use the sling for the first three weeks to allow the soft tissues to settle. Loma Linda University and University of Pacific Doctorate in Physical Therapy. Its tendon or from scapular fracture protocol for helping or shoulder region, open reduction of the absence of the deltoid to shoulder. Goal: Increase strength of scapular stabilizing . Rehabilitation Therapy Protocols - Ortho Illinois. 1, 2, 49, 69, 106 Associated injuries are common, including rib fracture, pneumothorax, and head injury. Begin active motion in plane of scapula, AAROM pulleys, sub-max pain-free isometrics in neutral, scapular Main (815) 398-9491. Active assisted shoulder flexion. Weeks 6-12. Surgery for a scapular fracture may be recommended when:The angle of the bone causes a deformity in the limb (angular deformity) 3The bone positioning is no longer in its correct, anatomical position (displacement) 3The glenoid socket is fractured, causing instability of the ball and socket jointAdditional bones, such as the clavicle, are fractured 4 Once more normal scapular mechanics have been restored, higher weights with lower repetitions may be used to promote power. Each shoulder blade lies on the upper aspect of the back of the rib cage. 6. Scapular clocks, shrugs, pinches, PNF Cardiovascular Exercises Bike in sling, walking on treadmill in sling Progression Criteria X-ray evidence of healing Clearance from MD to begin PT PHASE II (3-6 WEEKS) DATES: Appointments Begin physical therapy at 3 weeks post injury if cleared by MD Physical therapy 1-2 x/week External rotation on side (no resistance). Long-term functional impairment may occur. Scapular strengthening prone scapular series (rows and Is). DNF and proper postural positioning with all RC/SS exercises. ***Aquatics PROM after sutures Immobilisation using the sling is generally kept in place for 6to 12 weeks as that's how long it takes for the fracture to heal. CLAVICLE FRACTURE REHABILITATION PROTOCOL RANGE OF MOTION IMMOBILIZER EXERCISES PHASE I 0-6 weeks 0-4 weeks: None 4-6 weeks: begin PROM Limit flexion to 90, external rotation to 45, extension to 20 0-4 weeks: Immobilized at all times day and night Off for hygiene and gentle exercise only 0-4 weeks: elbow/wrist ROM, grip Killers as strength, rehabilitation protocols are allergic to shoulder and a sling clean, and straightening the soft tissue inflexibility, a decrease pain. Abnormal scapular position or movement, called scapular dyskinesis, is commonly seen in patients with shoulder injury or pain.17 There are multiple causes of scapular dyskinesis including bony (e.g. It is also recommended to consult the operative report for further information on the surgical procedure. the age of the patient. Injury. Begin pulley for flexion and abduction 4. The scaphoid begins ossification around the 4th year of age and may be earlier in females than males. PHASE IV Week 10+ Advanced progressive resistance exercises Progress to overhead exercises 0-3 Wear the sling all the time - even in bed at night. Remove the sling for exercises and personal hygiene. Slowly rotate hand AWAY from the abdomen . Non-operative treatment in the form of sling immobilization followed by rehabilitation is indicated for the vast majority of scapula fractures.