Humerus Fractures: Recovery, Rehabilitation, and Plate Removal

Humeral fracture

Hello, Doctor.
In early June of this year, I suffered a left humeral fracture due to a fall.
Currently, I can raise my arm to a certain height and angle, but I am unable to lift it beyond that.
I visited an orthopedic clinic, and they mentioned that I have joint stiffness and adhesion.
Will this condition improve with continued rehabilitation? Will I fully recover? I am also concerned about whether I should have the titanium alloy plate removed after one or two years.
Some doctors suggest removal, while others believe it is unnecessary.
I worry about the plate being a foreign object in my body for an extended period.
However, I read that if the plate is removed improperly, it could potentially damage the radial nerve, making it difficult to decide.
Do you think it is necessary to remove the plate, or is it harmless to leave it in?

Nai Mei, 20~29 year old female. Ask Date: 2019/10/26

Dr. Wang Shouji reply Orthopedics

Hello, if it is a mid-shaft humeral fracture, it should have a temporary impact on the shoulder joint, and the plate is unlikely to affect shoulder joint mobility.
However, if it is a proximal humeral fracture, there may be some impact on shoulder joint function, and removal of the plate could be considered, as it is located farther from the radial nerve, which generally does not affect nerve function.
The presence of a titanium alloy plate does not have a significant impact if left in place.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2019/10/26

More Info

Understanding humerus fractures and their recovery process is crucial for patients who have experienced such injuries. When a humerus fracture occurs, particularly in the context of an accident or fall, it can lead to significant complications, including joint stiffness and the potential need for surgical intervention to remove hardware like plates or screws used during the initial repair.

In your case, it seems that you are experiencing some degree of joint stiffness and adhesive capsulitis, commonly known as "frozen shoulder." This condition can occur after a fracture due to immobilization during the healing process. The stiffness you are experiencing, especially when trying to lift your arm, is not uncommon. With consistent and appropriate rehabilitation, many patients see improvements in their range of motion and overall function. Physical therapy is essential in this phase, focusing on gentle stretching and strengthening exercises to gradually restore mobility. Techniques such as manual therapy, ultrasound, and electrical stimulation may also be beneficial in reducing stiffness and promoting healing.

Regarding the titanium plate that was implanted during your surgery, the decision to remove it is often a topic of debate among orthopedic surgeons. Generally, if the plate is not causing any discomfort or complications, many surgeons recommend leaving it in place. The rationale is that the body can often adapt to the presence of the plate, and removing it carries risks, including potential damage to surrounding nerves, such as the radial nerve, which can lead to further complications.

However, if you are experiencing persistent pain, discomfort, or limitations in function that you believe may be related to the plate, it is reasonable to discuss the possibility of removal with your orthopedic surgeon. They can assess your specific situation, including the healing of the bone and the position of the plate, to determine whether removal is warranted.
In terms of recovery time, it varies significantly from person to person. Factors such as age, overall health, the severity of the fracture, and adherence to rehabilitation protocols all play a role. Generally, bone healing can take anywhere from six weeks to several months, while full recovery of function may take longer. It is essential to maintain open communication with your healthcare team throughout this process, as they can provide tailored advice based on your progress.

In summary, while joint stiffness after a humerus fracture is a common issue, with diligent rehabilitation, many patients can achieve significant improvements. The decision to remove a titanium plate should be made collaboratively with your orthopedic surgeon, weighing the potential benefits against the risks involved. Regular follow-ups and physical therapy will be key components in your recovery journey, helping you regain strength and mobility in your arm.

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