Personally I would be looking for a second opinion — I am not sure it will heal well without steel but your consultant knows more than me. Did mine a while back , had it operated on. The outcome was that the head of the humerous did not survive.
Never the same again, ever!!!! I broke mine at the end of June going over the bars. Very similar injury to yours by the sound of it, fractured just below the ball but also fractured the ball.
Initially plastered but after seeing consultant 2 days later decided on surgery as the ball had rotated and was not lining up with the bone closely enough. Had op on 6th July, 6 weeks in a sling glad I had the op, if only because the plaster was awful and started physio, now 12 weeks since op, all healed and doing physio and exercises to gain strength. Opinions when I can ride a bike off road again, seem to be around 9 months to a year, although I have been out on the street and intend to try a few miles on the flat this weekend on a local smooth trail.
I had a commutated fracture of my humerus a couple of inches below the ball joint. I had a detached flake on the outside. Just walking a mile into town and back for a coffee was enough to totally tire me out for hours. They had me doing some basic mobility exercises after a week too! I also had hydrotherapy which was wonderful. Just letting the arm float supported by the water was pure bliss, like getting your arm back I felt at the time. I couldnt even drive for three months. I downside I found was a distinct lack of bottle afterwards in case I landed on the arm.
Guy in my physio group spent 6 months on morphine because of his pain after the op. And yes my arm has healed okay, and been fallen on as well. I was riding again after 5 months. I was doing private physio 3 times a week the week after operation.
NHS physio was a joke Addenbrookes in Cambridge. Well worth paying for. If you do have metalwork ask if they expect to take it out again — my leg has been a lot better since I had my bolts removed a couple of years after the initial op. Finally, do the physio until your eyes water with the pain. And then do it some more — it really is key to getting full movement and strength back. Having surgery simply aligns the bones so they can heal by themselves — the metalwork is rarely good enough to weight bear.
It may be worth getting a second opinion just to set your mind at ease, but I would be surprised if it made a great deal of difference. Looking forward to filling loads of paperwork out with a broken right arm! I did mine back in Learn More.
Gallen, Rorschacherstr. Gallen, Switzerland. We investigated whether there is a relationship between subjective or objective outcome measures and the ability and time for returning to work RTW after a proximal humerus fracture PHF. Retrospective single-centre study from March to June Primary interest was the comparison of the outcome scores with the time needed for RTW.
Jobs which require higher physical demands were likely to influence and to delay RTW. We were able to show, that besides age, sex and fracture, the type of occupation might alter the scores in postoperative outcomes. There are many different and well-known shoulder outcome measures that gauge pain and function. Researchers and clinicians, trying to classify the outcome after a certain operation, use these scores frequently.
In recent literature, not only the degree of functional impairment of the affected joint or extremity, but also measures of general health and social implications have gained more interest. Newer questionnaires often combine subjective and objective components. However, the goal of rehabilitating any injured patient should be functional independence and return-to-work RTW.
By itself, the functional assessment is non-descriptive of these two goals. If value is defined as patient outcomes in relation to healthcare costs, we need to collect information about both [ 1 , 2 ]. In the future, orthopaedic and trauma surgeons might be evaluated and compensated by implementing value-based health care.
Therefore, it is important to measure patient-centred and risk-adjusted patient specific outcomes. The purpose of this study was to find out if there is a relation between subjective or objective outcome measures and the ability to RTW. It would be useful to be able to define a certain cut-off value for shoulder function, which allows RTW after a shoulder operation.
Additionally, we wondered if employees who still had limited range of motion were able to return earlier, if they did not have a physically challenging occupation. Since we were interested especially in the population of working people, we defined an age limit of 65 years.
In Switzerland where the study was performed, there is a retirement benefit starting at the age of 65 years. Exclusion criteria were the above-mentioned age limit, unemployment at time of injury, multiple injuries and pathologic fractures.
Indication for operative treatment was based on fragment displacement as described by Neer [ 4 ]. Patients were asked to participate in routine follow-up including X-ray, a physical examination CMS and the completion of the SF questionnaire at 1. The patient completed the SF unaided. A study nurse checked for completeness. None of the patients had an examination at the exact day of RTW.
Thus, to get the most applicable cut-off values for that day, we only evaluated patients with examinations within 7 days before or after their RTW for this specific calculation. RTW was defined as the time in days until a patient was able to fully return back to his or her former occupation again. Reliability and validity have been well documented by the developers of this instrument [ 6 - 10 ]. Calculation of the scores and the scoring checks were performed in accordance with the SF Manual and Interpretation Guide [ 6 ].
A clinician performed the examination. For strength testing we used a mechanical dynamometer. Scores range from 0 to , with a high score indicating less pain and better function.
Final scores were adapted to gender and age and classified from poor to very good, analogous to Neer [ 4 ] as described and proposed by Tingart [ 12 ]. A difference of 10 points was interpreted as clinically relevant [ 4 , 12 ]. Beach-chair position, deltopectoral approach and general anaesthesia were performed exclusively.
Pendulum exercises of the shoulder were initiated 7 days after the intervention. Continuous variables are presented as the mean and standard deviation. Comparison between different groups was performed with the use Student-T-test. All operations were performed within the first 10 days after injury. There has been one revision due to an early hematoma, which had to be evacuated surgically. Bacterial infection was found and antibiotic treatment was started.
The patient recovered well in follow-up. The median follow-up was days , while the mean time in hospital was 7 days [one patient had additional soft tissue injuries, which required a longer hospital stay]. Fu at RTW: Documenting the time when the follow-up examination prior to or after the RTW took place at our institution including only the patients who had one 7 days prior to or after RTW. Although not statistically significant throughout, all the scores were lower in the PW group after 3 months Fig.
The figures a-d show the scores and its compounds of the OW and PW during the different follow-up examinations after the shoulder operation. Fractures of the proximal humerus have a peak incidence in woman older than 50 years and in men between 30 and 50 years [ 13 ]. Considering these age-related incidences of PHF, men especially are prone to be absent from their work after such a trauma, which is an economic burden.
Shoulder pendulum exercises. Stand and lean forward supporting yourself with your other hand. Try to relax your injured arm and let it hang down. Continue for approximately minutes in total provided there is no increase in symptoms. Remember to try and relax your arm. Active assisted External rotation. Keep the elbow of your injured arm tucked into your side and your elbow bent.
Use your unaffected arm to push your injured hand outwards. Remember to keep your elbow tucked in. Push until you feel a stretch. Hold for 5 seconds and then return to the starting position.
Repeat 10 times provided there is no increase in symptoms. When you have regained full range of movement in the stage 2 exercises without pain you can start to do these exercises without the support of your other hand. This is known as active range of movement. The, when you have regained full movement without helping with your other arm, you can build up your regular day to day activities.
Perform these exercises 10 times each. Only go as far as you can naturally, without doing any trick movements to try and get any further. The movement should increase over time and should not be forced. With your elbow by your side, rotate your forearm outwards, keeping your elbow at about 90 degrees in flexion. Toggle navigation Virtual Fracture Clinic. Virtual Fracture Clinic. Proximal humerus fracture Proximal humerus fracture. About your injury: The shoulder is a ball and socket joint and you have fractured the ball part.
Healing: This injury normally takes weeks to heal. Pain: Take pain killers as prescribed. You may find it easier to sleep propped up with pillows.
Using your arm: It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury. Follow the management plan below. Follow up: The fracture is in a good position and only has a small chance of moving. Area of your injury If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice. What to expect Weeks since injury Rehabilitation plan Wear your sling all the time - even in bed at night.
Advice for a new injury Cold packs: A cold pack ice pack or frozen peas wrapped in a damp towel can provide short term pain relief. Smoking advice Medical evidence suggests that smoking prolongs fracture healing time. Exercises If you have stiffness in your elbow or hand from wearing the sling, you may wish to perform these exercises first. Initial exercises to do times a day: Finger and wrist flexion and extension Open and close your hand as shown times.
Then move your wrist up and down times. Hold for 5 seconds and repeat 10 times.
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