Post-Surgery Care for Proximal Humerus Fracture: Key Recovery Tips

Post-operative issues following a comminuted proximal humeral fracture surgery?

Hello Doctor, my family member (56 years old) suffered a comminuted fracture of the proximal humerus due to a car accident.
The hospital has assessed that surgery is necessary for treatment.
Since the patient’s job requires lifting heavy objects, I would like to ask the doctor what steps should be taken after the surgery to return to the pre-accident condition.
What impact could occur if the patient accidentally lifts something too heavy? Thank you for taking the time to answer.

Worried Family, 20~29 year old female. Ask Date: 2018/12/16

Dr. Li Yongheng reply Orthopedics

Hello, active rehabilitation therapy should begin 4-6 weeks after surgery.
Typically, light work capabilities can be restored after 3 months post-surgery, general work capabilities after 6 months, and heavy work capabilities after 1 year.
However, a proper recommendation can only be made based on X-ray examinations.

Reply Date: 2018/12/16

More Info

Post-surgery care for a proximal humerus fracture, especially after a significant injury like a car accident, is crucial for optimal recovery. Here are some key recovery tips and considerations for your family member, who is 56 years old and has a history of heavy lifting in their job.

Immediate Post-Surgery Care
1. Follow Medical Advice: After surgery, it is essential to adhere strictly to the orthopedic surgeon's instructions. This includes medication for pain management, wound care, and any prescribed physical therapy.

2. Immobilization: The arm will likely be placed in a sling or brace to immobilize the shoulder joint. This is vital for allowing the fracture to heal properly. The duration of immobilization can vary but typically lasts for several weeks.

3. Pain Management: Pain control is important for recovery. Patients should take prescribed pain medications as directed and report any severe or worsening pain to their healthcare provider.

4. Wound Care: Keep the surgical site clean and dry. Follow the surgeon's instructions regarding bathing and changing dressings. Watch for signs of infection, such as increased redness, swelling, or discharge.

Rehabilitation and Physical Therapy
1. Start Physical Therapy Early: Once cleared by the surgeon, starting physical therapy is crucial. Early rehabilitation can help restore range of motion and prevent stiffness. The therapist will guide the patient through gentle exercises tailored to their specific condition.

2. Gradual Increase in Activity: The rehabilitation process should be gradual. Initially, focus on passive range-of-motion exercises, progressing to active exercises as healing allows. The therapist will monitor progress and adjust the rehabilitation plan accordingly.

3. Strengthening Exercises: Once the initial healing phase is complete, strengthening exercises will be introduced. This is particularly important for someone who needs to return to heavy lifting. The therapist will provide exercises that target the shoulder muscles and improve overall stability.

Returning to Work and Lifting
1. Gradual Return to Work: Depending on the severity of the fracture and the surgery, returning to work may take time. It is essential to have a discussion with the surgeon about when it is safe to resume heavy lifting. Typically, this could take several weeks to months, depending on the healing process.

2. Avoid Heavy Lifting Initially: Lifting heavy objects too soon can lead to complications, including re-injury or improper healing of the fracture. It is crucial to follow the surgeon's advice regarding lifting restrictions.

3. Use Proper Lifting Techniques: Once cleared to lift, using proper techniques is vital. This includes bending at the knees, keeping the load close to the body, and using the legs for strength rather than the back or shoulders.

Long-Term Considerations
1. Monitor for Complications: After surgery, it is essential to monitor for any signs of complications, such as persistent pain, swelling, or decreased range of motion. If these occur, contact the healthcare provider immediately.

2. Lifestyle Modifications: Depending on the recovery, lifestyle changes may be necessary to prevent future injuries. This could include ergonomic assessments at work and learning safe lifting techniques.

3. Regular Follow-Up: Regular follow-up appointments with the orthopedic surgeon are crucial to monitor healing and adjust rehabilitation plans as needed.

Conclusion
Recovering from a proximal humerus fracture requires a comprehensive approach that includes proper post-surgery care, rehabilitation, and gradual return to work. It is essential to follow medical advice closely and communicate any concerns with healthcare providers. With dedication to rehabilitation and adherence to safety guidelines, your family member can work towards regaining strength and function in their shoulder, ultimately returning to their pre-injury work capacity.

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