Post-Humerus Fracture: Addressing Complications and Rehabilitation Strategies

Post-fracture complications of the humerus?

Dr.
Chen, I apologize for the questions I asked a few days ago, but I have a few more things I would like to inquire about.

1.
Last time, you mentioned that a bone fragment in the shoulder joint might be the reason for the inability to lift the arm.
Is there any way to improve this condition? Additionally, if osteoporosis is present, would increasing calcium intake be beneficial?
2.
Will continuing rehabilitation exercises against the wall have a positive effect, considering there is a bone fragment stuck there? If I keep pushing through or forcefully lifting, could it cause any adverse effects?
3.
Lastly, my mother had a follow-up appointment a couple of days ago.
The original surgeon mentioned that for this year, she should focus on actively moving the joint in all directions, as the joint will stabilize after about a year.
The extent of recovery will depend on how this year goes, so is this year indeed a critical period for rehabilitation before it stabilizes?
I have quite a few questions, and I appreciate your help once again.
Thank you!

Jason, 30~39 year old female. Ask Date: 2021/02/23

Dr. Chen Yongxue reply Orthopedics

Hello,
1.
Last time we mentioned that a bone fragment in the shoulder joint might be the reason for the inability to raise the arm.
Is there a way to improve this condition?
ANS: If so, it would require another surgery.
Additionally, if osteoporosis is present, would increasing calcium intake be helpful?
ANS: Yes.
2.
Will continuing rehabilitation exercises against the wall have a positive effect?
ANS: Yes, passive movements can be beneficial, especially since there is a bone fragment stuck there.
Will repeatedly trying to lift it or forcing it cause any issues?
ANS: No.
3.
Lastly, my mother had a follow-up appointment a couple of days ago.
The original surgeon mentioned that for this year, she should focus on moving the joint in all angles, as it will take about a year to stabilize.
The extent of recovery will depend on how this year goes, so is this year indeed a critical period for rehabilitation before it stabilizes?
ANS: Yes.

Reply Date: 2021/02/23

More Info

After a humerus fracture, complications can arise that significantly affect rehabilitation and recovery. Based on your questions, let’s address the issues surrounding the bone fragment, osteoporosis, rehabilitation exercises, and the critical period for recovery.

1. Bone Fragment and Mobility: The presence of a bone fragment in the shoulder joint can indeed limit your range of motion and cause pain. If this fragment is causing mechanical blockage, it may require surgical intervention to remove it. However, if the fragment is not causing significant issues, physical therapy may help improve your range of motion over time. Engaging in gentle exercises that promote mobility without exacerbating pain is crucial. If you have not already, consider consulting with an orthopedic specialist who can assess the need for further imaging, such as an MRI, to evaluate the fragment's position and its impact on your shoulder function.

2. Osteoporosis and Calcium Intake: If osteoporosis is a concern, increasing your calcium intake can be beneficial, but it should be part of a broader strategy that includes vitamin D supplementation and weight-bearing exercises. Calcium-rich foods include dairy products, leafy greens, and fortified foods. However, dietary changes alone may not be sufficient to manage osteoporosis. It's essential to discuss with your healthcare provider about potential medications or treatments that can help strengthen your bones and reduce the risk of future fractures.

3. Rehabilitation Exercises: Continuing rehabilitation exercises, such as wall slides or pendulum exercises, can be beneficial as long as they are performed correctly and do not cause excessive pain. It’s important to listen to your body and avoid pushing through pain, as this can lead to further injury. If a bone fragment is indeed causing a blockage, certain movements may need to be modified or avoided altogether. Working closely with a physical therapist can help tailor a rehabilitation program that accommodates your specific condition while promoting healing.

4. Critical Period for Recovery: The first year post-fracture is indeed a crucial time for rehabilitation. During this period, the body heals, and the joint can regain function. The extent of recovery can vary significantly among individuals and depends on factors such as age, overall health, adherence to rehabilitation protocols, and the nature of the injury. After this year, while some improvements may still occur, the potential for significant changes diminishes as the joint stabilizes. Therefore, it’s vital to maximize your rehabilitation efforts during this time.

In summary, addressing the complications from a humerus fracture involves a multifaceted approach that includes potential surgical intervention for bone fragments, dietary adjustments for osteoporosis, and a tailored rehabilitation program. It’s essential to maintain open communication with your healthcare providers to ensure that your recovery is on track and to make adjustments to your treatment plan as necessary. Regular follow-ups and adherence to rehabilitation exercises will be key to optimizing your recovery and restoring function to your shoulder.

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