The associated injuries may be multiple and/or life-threatening. Call Main Office for.. • General Questions • Schedule an Appointment. Rowe 90, 91 reported that 71% of the patients in his series of scapular fractures … As stated, high speed automobile accidents, blunt trauma, or significant fall are some of the causes of a Scapula Fracture or Broken Shoulder Blade. The clavicle lies (779) 771-7000. Clavicle Fracture. The Orthopaedic and Fracture Clinic 1431 Premier Drive Mankato, MN 56001 507-386-6600 Dr. Allen Olecranon Fracture Repair Rehabilitation Protocol Phase I: Protection (Weeks 0-6) Weeks 0-2 -First post-op visit at ~2 weeks -Leave splint in place until first visit (bag on arm to shower) -Arm will be splinted at 90° for the first 2 weeks Bony healing occurs usually within 6 to 8 weeks in adults ... Scapular Stabilization a. Scapular clocks b. Scapular retractions (no shoulder extension) Your diagnosis is: Scapula (shoulder blade) Fracture The scapula is the triangle shaped bone at the back of the shoulder. 2013 Jul;7(3):105-9. doi: 10.4103/0973-6042.118911. Used for sleeping only for weeks 6-8. ! Cervical ROM as needed to maintain full mobility. Shoulder Fracture Fixation. Once more normal scapular mechanics have been restored, higher weights with lower repetitions may be used to promote power. Nonoperative Treatment of Proximal Humerus Fracture Rehabilitation Considerations o Usually nonoperative care is selected for those patients O thopae ic institute of Ohio Samir Patel, who are medically unfit for surgery or have a minimally to nondisplaced fracture o Depending on the severity of the fracture the best outcome may To help prevent a recurrence of the injury, your physical therapist may advise you to:Maintain good, upright posture and avoid slouching.Maintain the strength in your scapula and shoulder joint muscles.Use proper athletic techniques when performing sports that require overhead arm movements. Injury. sternal fracture. Prognosis. Clinical and radiological examination. Active assisted shoulder flexion. ! CLAVICLE FRACTURE REHABILITATION PROTOCOL RANGE OF MOTION IMMOBILIZER EXERCISES PHASE I 0-6 weeks 0-4 weeks: None 4-6 weeks: begin PROM Limit flexion to 90°, external rotation to 45°, extension to 20° 0-4 weeks: Immobilized at all times day and night Off for hygiene and gentle exercise only 0-4 weeks: elbow/wrist ROM, grip Bend and a treatment protocol for classification for me and Try not to aggravate it. The sling is usually kept for comfort for the first two weeks with subsequent increase of the shoulder’s range of motion. size of surgery. Complete LSSS failure, Floating shoulder, Ligament repair 3. Pain medication, including acetaminophen, can help relieve pain as the fracture heals. 2) A rope and pulley assembly. Day 1 - 3 weeks To date, it is not clear how these... | … Scapular Shoulder Stabilization . We therefore used a prospectively collected database and a uniform CT protocol to (1) evaluate the functional outcome after nonoperative management of displaced scapular body fractures as assessed by change in the DASH score; (2) determine the radiographic outcome assessed by the change of the GPA; and (3) identify associated scapular and … Loma Linda University and University of Pacific Doctorate in Physical Therapy. 5,38,47 Coracoid fractures have been reported to account for 0% to 7% of all scapular fractures, based on studies using plain radiography. pneumothorax and/or pulmonary contusion. Keep arm in plane of scapula Week 3 – 4 AAROM and Isometrics Week 3 Active Assisted ROM 1. Goal: Regain full pain-free ROM of elbow and prevent shoulder and wrist stiffness. Gently lift your arms straight out in front of you, perpendicular to your torso. 2. The … Please use this protocol and the information below to guide this patient’s rehabilitation. Begin gentle Theraband resistive exercises at five weeks. Each shoulder blade lies on the upper aspect of the back of the rib cage. ! Scapula fractures are frequently the result of high-energy trauma thus there should always be concern for associated injuries and a complete physical exam should be performed. Treatment: The majority of fractures are treated non-operatively. This is a very common fracture that occurs in people of all ages. 3 … Proximal Humerus Fracture Rehabilitation Protocol Your shoulder rehabilitation program begins while you are in the hospital. Keeping your arm at your side, bend and straighten the elbow, flex the wrist, hand and fingers. Three times a day. • Scapular clocks, shrugs, pinches, PNF Cardiovascular Exercises • Bike in sling, walking on treadmill in sling Progression Criteria • X-ray evidence of healing • Clearance from MD to begin PT PHASE II (3-6 WEEKS) DATES: Appointments • Begin physical therapy at 3 weeks post injury if cleared by MD • Physical therapy 1-2 x/week Phase I (0 to 7 days) Hand and Finger ROM. Rehabilitation protocol adopted from the Massachusetts General Hospital Sports Physical Therapy program and the American Academy of Orthopedic Surgeons for non-surgical rehabilitation of clavicle fractures (7,15). Used for sleeping only for weeks 6-8. Scapula fractureStage 2 exercisesStart these exercises 3 weeks post injury and to do 4-5 times a day: Use your other hand to lift your arm up in front of you as shown in ...Active Forward flexion: With your thumb facing up, try to move your arm up, keeping it close beside your body. ... Protocol must be altered based on fixation strength at surgery and surgeon preference. • May begin scapular retraction and depression *Sling Arm in sling at all times for 2 weeks except for exercises and bathing (includes nighttime) Other • Continue Cryotherapy • Incision mobilization and desensitization • Modalities to decrease pain and inflammation !1 – Shoulder Fracture ORIF: Postoperative Protocol 1lb limit. Nonoperative Treatment of Proximal Humerus Fracture Rehabilitation Considerations o Usually nonoperative care is selected for those patients O thopae ic institute of Ohio Samir Patel, who are medically unfit for surgery or have a minimally to nondisplaced fracture o Depending on the severity of the fracture the best outcome may Scapula Body Fracture – ORIF.....27 Humeral Shaft Fracture – Non-Operative .............................................................................28 Humeral Shaft Fracture – ORIF .............................................................................................29 Associations. ... Scapular retraction Office Visit Call 617-726-7500 to reach your doctor; 617-643-9999 to reach MGH Sports Physical Therapy. Most series report motor vehicle or motorcycle accidents as the cause of injury in more than 50% of the cases. Emphasize scapular strengthening under 90°. Scapula fractures are commonly the result of high-energy injuries [4, 25, 37].Associated injuries are frequent. • Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day. • Passive ROM: flexion and abduction to 90°, ER as tolerated with elbow at side, IR to 45° with elbow away from side in supine Non-Operative Proximal Humeral Fracture Rehabilitation Protocol General Principles: 1. Killers as strength, rehabilitation protocols are allergic to shoulder and a sling clean, and straightening the soft tissue inflexibility, a decrease pain. Low to moderate cardiovascular work. The socket of the shoulder joint is a part of the scapula. 2. Appointments Continue physical therapy 1-2 x/week Rehabilitation Goals • Increase RTC strength • Restore scapula-humeral rhythm Precautions • None Suggested Therapeutic Exercises • Posterior capsule stretching if indicated • Isotonic exercises for RTC, scapular muscles • PNF • Theraband rows, ER, IR, shoulder extension 4. Scapula fractures rarely require surgery. Scapular strengthening – prone scapular series (rows and I’s). Rehabilitation Scapular Winging SC Joint Shoulder Arthroplasty Shoulder Instability ST … Prone scapular retraction exercises without weights Biceps and triceps exercises without weight Stairmaster ... Lee, Bong Gun, Nam Su Cho, and Yong Girl Rhee. DNF and proper postural positioning with all RC/SS exercises. Ice. Repeat 12 -15 times . It might take a few days practice to feel comfortable with them. Lie on your back or sit upright in a chair with your arms in front of you relaxed on your thighs. SHOULDER ANATOMY External Rotation Attach theraband to a stable object at waist level Roll shoulders back and down and maintain this position . Scapula fractures represent less than 1% of all broken bones and many of them can be treated without surgery. Goal: Increase strength of scapular stabilizing . Express. Start the "Initial Exercises" straight away, ideally within the first 72 hours. Attachments and scapula fracture treatment protocol for scapula fractures dictate an improved understanding of the bones at. Limited by pain. External rotation on side (no resistance). A scapula fracture is an uncommon injury. AAROM>AROM as tolerated; PROM Goals: FF 120°, ER 50°, IR 50°, Active FF 100°. Clavicle fractures are very common injuries in adults (2–5%) and children (10–15%) and represent the 44–66% of all shoulder fractures. They are often caused by high energy blunt trauma such as a fall from height. The shoulder blade (scapula) is a triangular-shaped bone that is protected by a complex system of surrounding muscles. You have sustained a fracture to your scapula (shoulder blade). Apply hot packs 10 minutes before exercising 2. Fractures of the scapula are rare and usually associated with high-energy trauma. Scapular fractures can be categorized by the affected region of the bone: namely, the coracoid, the acromion, the glenoid, the scapular neck, and the scapular body. Protect Clavicle: Arm sling for 6 weeks 2. The typical rehab protocol for conservative treatment is as follows (time frame two to six months (4)): Immobilize using a sling and swathe for comfort (for up to six weeks). The scapula, or shoulder blade, is the triangular-shaped bone on each side of your upper back. A scapula fracture is an uncommon condition (accounting for approximately 1% of all fractures) and is characterized by a break in the shoulder blade (scapula) (figure 1). Int J Shoulder Surg. Begin pendulum (Codman) exercises 3. T-stick in 0-20 deg flexion and 20 deg abduction. 5. Scapula. Most fractures of the scapula can be treated without surgery. Summary. This step-by-step guide is similar to a shoulder program your PT may use during your rehab to help you get control of your scapula. Nonsurgical treatment with a shoulder immobilisation sling works best for most fractures of the scapula. 1) An exercise bar, which lets the patient use the uninjured left shoulder to passively move the affected right side. C-spine AROM. 1992;20;128-134. This case report describes the physical therapy intervention for a patient with an open reduction and internal fixation of a scapula fracture with decreased shoulder strength, Description. Shoulder shrugs and retractions (no weight) ***Pain control modalities PRN. Post-Operative Rehabilitation following ORIF Clavicle Fracture A broken collarbone is also known as a clavicle fracture. Hold 3 sec. The unfavorable scapular anatomy, combined with the complexity of the approaches for fracture fixation, make the treatment challenging, even for experienced surgeons. 1, 2, 49, 69, 106 Associated injuries are common, including rib fracture, pneumothorax, and head injury. Weeks 6-12. Scapula (Shoulder Blade) Fractures. Begin gentle passive ROM above shoulder level. Rehabilitation Protocol for Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF) ... • Scapular retraction and mobility exercises Criteria to Progress ... displaced proximal humerus fractures in the elderly: A prospective study. Scapula fractures have a high association with concomitant injuries. Expect to spend six months to one year recovering from … PDF | Background: Acromial Levy III fractures after inverse shoulder arthroplasty occur in up to 7% of patients. 1lb limit. Tears of muscles that pain and Depending on how severe the fracture is, you might need to start exercises within a week after the injury, while others require two to four weeks before beginning the exercises. Main (815) 398-9491. Bending over to perform pendulum exercises is recommended 3 … AAROM>AROM as tolerated; PROM Goals: FF 120°, ER 50°, IR 50°, Active FF 100°. Surgery for a scapular fracture may be recommended when:The angle of the bone causes a deformity in the limb (angular deformity) 3The bone positioning is no longer in its correct, anatomical position (displacement) 3The glenoid socket is fractured, causing instability of the ball and socket jointAdditional bones, such as the clavicle, are fractured 4 Scapular Stabilization a. S/L scapular clocks b. Clasp your hands together, straighten your elbows, and relax your affected shoulder. Adam Seidl, MD Highlands Ranch Hospital Assistant Professor (720) 516-4090 Shoulder/Elbow Surgery Inverness Department of Orthopedics (303) 694-3333 University of Colorado Anschutz Medical Campus (720) 848-1900 Rehabilitation Protocol Apply cold packs to the shoulder 20 minutes each hour to reduce pain and swelling. Complete LSSS failure, Floating shoulder, Ligament repair 3. • Anterior deltoid strength and scapular stabilization • General UE strengthening Cardiovascular Exercises • No restrictions Progression Criteria • DC to HEP References: Godges, Joe, DPT, MA, OCS. ! fracture), neurologic (e.g. 0-3 Wear the sling all the time - even in bed at night. Clinical and radiological examination. A fall onto the lateral shoulder most frequently causes a clavicle fracture. Three times per day home exercise program including: Phase 1: Week 0-2. • Maintain sling use (except for TID elbow wrist finger ROM, hygiene) o Elbow should be supported • No lifting > weight of coffee cup o No active shoulder ROM • Begin TID HEP for elbow wrist finger ROM. Indicated for non-op treatment or ORIF. Fixation of Proximal Humerus, Clavicle, Scapula and Glenoid fractures. About. Remove the sling for exercises and personal hygiene. Non-displaced means less than 1cm of displacement and less than 45° of angulation 2. When available 196 data was pooled from nine studies that compared the rates of scapula spine fractures between 197 implant designs, the increase in the incidence of scapular spine fractures in the onlay group was 198 not statistically significant (p=0.09). Rehabilitation Protocol Humeral Shaft Fracture (ORIF) PHASE I: Protected ROM (6 weeks) • Keep dressing in place, you may shower directly over clear plastic. What’s Causing Unstable Shoulders?Use it or lose it! The sad truth is, most of us don’t learn how to control or use our scapulae properly. ...Posture. Surprise, surprise! ...Overtraining. Overtraining certain exercises, although likely done in an attempt to stay fit, can actually contribute to shoulder instability.Misinformation. ... This normally takes between 6-12 weeks to unite (heal). brachial plexus injury. The scapula joins with the long bone of the upper arm (humerus) to form the shoulder joint (figure 1). FRACTURES JOINT REPLACEMENT SPORTS MEDICINE CLAVICLE FRACTURE ORIF PROTOCOL (Dr. Sean Griffin) Weeks 1-3 • Full time in sling • Avoid IR behind the back, lifting more than 1-2 lbs, and horizontal adduction. long thoracic or accessory nerve palsy), and muscular dysfunction (e.g. Remove the sling several times a day. Rate of recovery and the prognosis from scapular fracture will depend on a number of factors: Severity – Minor fractures do well with immobilization and physical therapy, while fractures that are more severe and require surgery or effect joint integrity take longer to recover.Patients may have residual motion and strength deficits, especially if the rotator cuff is … Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. It is the most common fracture of childhood. Research shows that 80-95% of scapula fractures have associated injuries. Begin active motion in plane of scapula, AAROM pulleys, sub-max pain-free isometrics in neutral, scapular … Seated scapular retractions Week 3 – 4 AAROM and Isometrics 1. Non-operative treatment in the form of sling immobilization followed by rehabilitation is indicated for the vast majority of scapula fractures. A 53-year-old-man with decreased left shoulder strength resulting from a 9-week period of inactivity following his surgery received physical therapy Phase 2: Week 2-6. • Use sling except with hygiene and therapy • … Forward Flexion. A clavicle fracture is also known as a broken collarbone. Use the sling for the first three weeks to allow the soft tissues to settle. Begin a progressive range of motion exercises as soon as the pain subsides. Its tendon or from scapular fracture protocol for helping or shoulder region, open reduction of the absence of the deltoid to shoulder. Townsend H, Jobe FW, Pink M, Perry J. Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program. PHASE IV Week 10+ Advanced progressive resistance exercises Progress to overhead exercises 10 reps, 2 x day. Scapular fractures occur relatively infrequently, accounting for 0.4% to 1.0% of all fractures. • Sutures are all underneath the skin and will dissolve on their own. the age of the patient. Continue passive ROM and scapular exercises. Indications: Proximal Humeral Fractures; Clavicle fractures ; Scapula / Glenoid fractures; This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase. Begin pulley for flexion and abduction 4. Scapular fractures are often associated with other injuries due to the high energy trauma that is usually the underlying cause: clavicle fracture. PHASE ONE: 0 – 4 Weeks Post-Injury Program GOALS: 1. Physical Therapy While you are wearing the sling, you will likely lose muscle strength in your shoulder. Pendulum (forwards/backward, side to side, and circles) After 3 weeks of healing: progress to light ADL activities. Abnormal scapular position or movement, called scapular dyskinesis, is commonly seen in patients with shoulder injury or pain.1–7 There are multiple causes of scapular dyskinesis including bony (e.g. 6. Strengthening: Begin gentle isometric exercises at four weeks. The Scaphoid bone is one of 8 carpal bones in the wrist. Rehabilitation Protocol: Post-Operative Cervical Spinal Fusion Department of Neurosurgery Lahey Hospital & Medical Center, Burlington 781-744-7580 Lahey Neurosurgery at Emerson Hospital 978-287-3194 ... scapular-thoracic re-education (shoulder shrugs, shoulder rolls, … Pendulum (forwards/backward, side to side, and circles) After 3 weeks of healing: progress to light ADL activities. Educate patient to mobilize neighboring joints immediately (elbow, forearm, hand) Prevent shoulder stiffness with exercises (10x each set, repeat 4-5x/day) for: Shoulder retraction. The scapula connects to the clavicle (collar bone) in the front of the body, and to the humerus (arm bone) at the side. Olecranon Fracture Rehab Protocol. Arc out which may heal, endurance using a complete range of this site of evidence. Sub-maximal isometrics. Frequency: 1 set. Passive flexion and ABD to 90°, ER as tolerated at 0° ABD, IR to as tolerated. Moseley JB, Jobe FW, Pink M, Perry J, Tibone J. EMG analysis of the scapular muscles during a shoulder rehabilitation program. Motion: Continue pendulum ROM exercises. spinal fracture. Rehabilitation Therapy Protocols - Ortho Illinois. Passive ROM > 90 degrees after week one. • Early rehabilitation should aim to improve the endurance and strength of the scapular stabilizing muscles. Scapula. Educate patient to mobilize neighboring joints immediately (elbow, forearm, hand) Prevent shoulder stiffness with exercises (10x each set, repeat 4-5x/day) for: Shoulder retraction. Call Injury Express for: • Urgent Care • Walk-In Injury Care.
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