Proximal Humerus Fractures: Recovery and Rehabilitation Insights - Orthopedics

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Proximal humerus fractures are common injuries, particularly in older adults or those involved in high-impact activities, such as car accidents. The recovery and rehabilitation process can vary significantly based on the severity of the fracture, the treatment approach, and individual patient factors. In your case, it appears that you opted for conservative management, which is often appropriate for non-displaced or minimally displaced fractures.

After a proximal humerus fracture, the initial treatment typically involves immobilization, which you have followed with a shoulder immobilizer for six weeks. This period is crucial for allowing the bone to begin healing. The fact that your physician has assessed the fracture as stable and healing well is a positive sign. However, it is not uncommon to experience pain during the rehabilitation phase, especially after removing the immobilization device. Pain can be attributed to several factors, including muscle stiffness, inflammation, and the process of the surrounding soft tissues adapting to movement after a period of immobilization.

Regarding your concern about the visibility of the callus (the white area on X-rays indicating healing) diminishing, this can sometimes be an optical illusion based on the angle of the X-ray or the healing process itself. As the bone heals, the callus may become less prominent as it remodels. However, if there is a concern that the fracture is not healing properly, your physician may recommend follow-up imaging or additional assessments.

It is essential to understand that pain during rehabilitation is not unusual, especially as you begin to engage in more active rehabilitation exercises. The increase in pain following rehabilitation sessions can be a sign of muscle fatigue or inflammation rather than a sign of re-injury. It is crucial to communicate with your physical therapist and physician about your pain levels, as they can adjust your rehabilitation program accordingly to ensure you are progressing without exacerbating your symptoms.

In terms of your recovery timeline, it is generally expected that patients may experience discomfort for several weeks to months post-fracture, especially during the transition from immobilization to active rehabilitation. Your current progress, moving from 80 degrees to 100 degrees of passive range of motion, is a good indication that you are on the right track. The goal is to gradually increase your range of motion while managing pain and preventing stiffness.

As you continue your rehabilitation, consider incorporating gentle strengthening exercises as advised by your physical therapist. This can help improve muscle function around the shoulder joint, which is essential for overall recovery and return to normal activities. If pain persists or worsens, or if you notice any new symptoms, it is crucial to follow up with your healthcare provider for further evaluation.

In summary, your recovery appears to be within a normal range for a proximal humerus fracture treated conservatively. Pain during rehabilitation is common, and the gradual increase in range of motion is a positive sign. Keep an open line of communication with your healthcare team, and do not hesitate to seek further clarification or adjustments to your rehabilitation plan as needed.