Can Surgery or Physical Therapy Fix a Stiff Arm After Humerus Fracture? - Orthopedics

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After a humeral fracture, particularly if it was treated conservatively with a cast and has resulted in stiffness or limited range of motion, there are several options to consider for rehabilitation and recovery. The decision between surgical intervention and physical therapy largely depends on the severity of the stiffness, the degree of functional impairment, and the specific findings from a physical examination or imaging studies.


Understanding the Condition
When a bone heals improperly or when there is a lack of movement during the healing process, it can lead to a condition known as joint stiffness or frozen shoulder (adhesive capsulitis). In your case, the stiffness in your arm after the humeral fracture could be due to several factors, including:
1. Scar Tissue Formation: After a fracture, especially if immobilized for an extended period, scar tissue can form around the joint, limiting mobility.

2. Muscle Atrophy: Lack of use can lead to muscle weakness and atrophy, which can further contribute to stiffness and discomfort.

3. Joint Contractures: Prolonged immobility can lead to the shortening of muscles and tendons around the joint, making it difficult to achieve full range of motion.


Treatment Options
1. Physical Therapy: This is often the first line of treatment for stiffness after a fracture. A physical therapist can design a rehabilitation program tailored to your specific needs. This may include:
- Range of Motion Exercises: Gentle stretching and mobility exercises can help improve flexibility and reduce stiffness.

- Strengthening Exercises: Once some range of motion is regained, strengthening exercises can help restore function and prevent future injuries.

- Manual Therapy: Techniques such as joint mobilization can be used to improve movement in the affected area.

- Modalities: Heat, ice, ultrasound, or electrical stimulation may be used to alleviate pain and promote healing.

2. Surgical Intervention: If conservative measures fail to provide relief or if there is significant structural damage (such as malunion or nonunion of the fracture), surgery may be considered. Surgical options could include:
- Arthroscopic Release: This minimally invasive procedure can help release tight structures around the joint.

- Open Surgery: In more severe cases, open surgery may be necessary to correct any underlying issues, such as removing scar tissue or realigning the bone.


Considerations
- Timing: The sooner you begin physical therapy after the injury, the better the outcomes tend to be. However, even years after the injury, physical therapy can still be beneficial.

- Pain Management: It’s important to manage pain effectively during rehabilitation. Over-the-counter pain relievers or prescribed medications may be necessary to facilitate participation in therapy.

- Commitment to Rehabilitation: Success in regaining function and reducing stiffness often requires a commitment to a regular exercise program and following the therapist's recommendations.


Conclusion
In summary, both physical therapy and surgical options exist for addressing stiffness after a humeral fracture. Given your history and current symptoms, starting with a comprehensive physical therapy program is advisable. This approach is less invasive and can yield significant improvements in mobility and function. If you find that physical therapy does not provide the desired results, you can then discuss surgical options with your healthcare provider. Always consult with a qualified orthopedic specialist to evaluate your specific situation and determine the best course of action.