Recovery Timeline and Expectations for Comminuted Humerus Fracture

Q: Recovery Timeline and Expectations for Comminuted Humerus Fracture

Amy： Proximal humeral comminuted fractures with severe displacement generally have a poor prognosis and often require joint replacement. <br>The recovery time depends on the healing status of the fracture. <br>It is recommended to visit an orthopedic specialist for further evalua

Comminuted fracture of the right humeral head?

I have a comminuted fracture of the right humerus near the shoulder, and I have been using a sling for treatment for five months.
Currently, I have limited range of motion in my arm and cannot raise it or extend it behind my back.
My arm is painful and swollen.
How long will it take for rehabilitation to achieve full recovery, and what degree of elevation can I expect in my arm after recovery? Right now, I can only raise it to 45 degrees.
Is my recovery progress normal?

Amy, 40~49 year old female. Ask Date: 2006/10/28

Dr. Wang Shouji reply Orthopedics

Amy: Proximal humeral comminuted fractures with severe displacement generally have a poor prognosis and often require joint replacement.
The recovery time depends on the healing status of the fracture.
It is recommended to visit an orthopedic specialist for further evaluation.
Wishing you a speedy recovery.

Reply Date: 2006/10/28

More Info

Recovering from a comminuted humerus fracture, especially one located near the shoulder, can be a complex and lengthy process. Given that you have been in treatment for five months and are experiencing limited range of motion, pain, and swelling, it is essential to understand the typical recovery timeline and what to expect moving forward.

Recovery Timeline
1. Initial Healing Phase (0-6 weeks): After a comminuted fracture, the initial healing phase focuses on stabilizing the fracture and allowing the bone to begin healing. During this time, immobilization with a sling or triangular bandage is common. Pain and swelling are expected, and physical activity is limited.

2. Early Rehabilitation Phase (6-12 weeks): Once the initial healing has occurred, typically around six weeks, your healthcare provider may recommend starting gentle range-of-motion exercises. This phase is crucial for preventing stiffness in the shoulder joint and maintaining some level of mobility. However, the extent of rehabilitation will depend on the stability of the fracture and the healing progress.

3. Strengthening Phase (3-6 months): After about three months, if healing is progressing well, you may begin a more structured rehabilitation program that includes strengthening exercises. This phase can last several months, and the focus will be on regaining strength and improving the range of motion.

4. Full Recovery (6-12 months): Full recovery from a comminuted humerus fracture can take anywhere from six months to a year or more. Factors such as age, overall health, and adherence to rehabilitation protocols can significantly influence recovery time.

Expectations for Range of Motion
Regarding your current ability to lift your arm only to 45 degrees, this is not uncommon in the early stages of recovery from a comminuted fracture. The shoulder joint is complex, and regaining full range of motion can take time. Here are some general expectations:
- At 3 months: Many patients can achieve about 60-90 degrees of shoulder flexion (lifting the arm forward).

- At 6 months: With consistent rehabilitation, many individuals can reach 90-120 degrees.

- At 12 months: Full recovery may allow for lifting the arm overhead (180 degrees), but this can vary widely.

Current Recovery Status
Your current recovery status, with the ability to lift your arm to 45 degrees, is within the normal range for someone who has experienced a comminuted fracture. However, the presence of pain and swelling indicates that your body is still healing. It is essential to continue working with a physical therapist who can guide you through appropriate exercises tailored to your specific condition.

Recommendations
1. Physical Therapy: Engage in a structured physical therapy program focusing on range of motion and strengthening exercises. Your therapist can provide modalities to manage pain and swelling, such as ice, heat, or electrical stimulation.

2. Home Exercises: Incorporate gentle stretching and mobility exercises at home, as advised by your therapist. Avoid pushing through pain, as this can lead to further complications.

3. Follow-Up Appointments: Regular follow-ups with your orthopedic surgeon or healthcare provider are crucial to monitor healing progress and adjust your rehabilitation plan as needed.

4. Patience and Persistence: Recovery from a comminuted fracture can be slow, and it is essential to remain patient and committed to your rehabilitation program. Celebrate small milestones along the way.

In conclusion, while your current range of motion is limited, it is not unusual for your stage of recovery. With continued rehabilitation and adherence to your treatment plan, you can expect gradual improvement in your shoulder function over the coming months. Always consult with your healthcare provider for personalized advice and adjustments to your recovery plan.

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