Fractured Humerus (nigh 12 weeks post-op)

[ash3r]

Hi everyone,

Just a little background info; below you'll see my discharge form and x-rays post-op.

My question at the moment relates to my range of movement... or lack of it!

In particular my lateral abductions. If you look at my x-rays, there are metal plates
that touch on (please forgive my lack of medical terminology here!) my shoulder when I abduct laterally and according to my PT, I won't get a huge ROM laterally, because of these...

FRUSTRATED!

I find it extremely hard to lift my arm up without getting a shoulder rise, it's almost impossible to do... How can I get better ROM? I'm determined to do whatever I can to get back to being as normal as I can be...

I find it really hard to stretch it out laterally, so I can hardly get the burning sensation, even when I try...

trying to get to a point here; is there any advice any of you can offer me?

Issues i'm hitting apart from what I've mentioned above are that I can't swing my arm from being on the side of me, to being in front of me if it's even slightly lifted above 20 degrees... it will give me _extreme_ pain, so it's something I've tried to concentrate on doing more of, when I'm in the pool...

---------------------
26 yo old left dominaint man admitted for fracture of right humerous on 09/07/08

he fell frm bike on corner, grazed his head as helmet slid back on
impact. he remained concious throughout incidemt.
there was mild headache but no amnesia afterwards.

he complained of pain and swelling in right shoulder

phmhx
Asthma - cntrlod by medication

on examination his airway n breathing were intact. he remained
haemodynamically stable GCS 15/15

there is a small graze to frontal region of forehead, and graze under
right eye.
he was neurologically intact.

Xray showed fracture of head of right humerous, xray for C-spine and
pelvis were normal.

he had open reduction and internal fixation for right humeral fracture
on 10/7/08 postop has progressed well.

plam 4 discharge:

follow up in fracture clinic in 2 weeks
first 2 weeks only passive movement of rght shlder joint, then active movement.
avoid rotating right arm more than 45 degrees

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[grovechick]

hi i have fractured humerus and have plates and pins like yours. did you ever get any response about movement cos its been 9 weeks so far since my op and i do not have movement at all.

[ash3r]

hi i have fractured humerus and have plates and pins like yours. did you ever get any response about movement cos its been 9 weeks so far since my op and i do not have movement at all.

Hi there,

you're welcome to send me an email if you need some advice or encouragement... It's been nearly 7 months since my operation now... And all I can say is, it does get better... But it's such a slow road... At the moment I can "basically" do everything that I could before... My movement is basically about 97% of what it was before my accident... it still doesn't feel normal.. I can tell there is metal in my arm.. it clicks, and gives slight pain... just sort of that dull ache you might get in your leg after running after having laid on your bed for 3 months without moving...


I never received any responses from anyone on this board, pretty slack!

If I can remeber my timeline.. it's been 7 months now, so it's kind of fading...

but I've heard that it can take upto 1 year before you'll feel normal again... and judging from my progress I'd say that's about right.

1st month is the worst: bed ridden, no energy, feel like fainting all the time, extreme pain when moving, unable to sleep
2nd month: pain starts to lessen, still unable to get any movement

just focus on following what your Physiotherapist tells you religiously

this is a good post that I found on an american mountain biking website, that gives some good advice, might be worth reading...

forums.mtbr.com/showthread.php?t=433885

If you have any questions you can send me an email to [email protected]

[physiobob]

Never noticed this post until today. I have taken a look at the x-rays and to be honest the humeral head does not look in the optimum position to permit full elevation. It looks depressed on the glenoid anteriorly and it looks posterior in the oblique view.

The metal work laterally is in a place that does not ever come into contact with the joint so that comment about it restricting range of motion is incorrect.

It also looks like there is trauma to the AC joint (collar bone and scapula articulation). This will restrict movement above 90 degrees in any plain and will cause excessive hitching of the shoulder on flexion and scaption/adduction.

I think perhaps you should have a review set of xrays and perhaps another physio opinion as I think your current one needs revising. I can't see the actual surface of the humeral head but if that is unaffected then full range should be able to be restored over time. The should is very good at inhibiting voluntary movement until it is well and ready to do so, whether you wish for it or not. Doint bilateral exercises to improve range under 90 degrees would assist initially e.g. light weighted seated-rowing exercises as this stage. All manner of external/internal balancing exercises to realign the humeral head on the glenoid should also be done (with arm by the side first, progessing to various ranges of scaption). The ACjt should be mobilised and the subscapularis and external rotator cuff mm's should be released to facilitate range as well.

Get youself into a good sport physio practice with a team that are focused and driven. Seems to me you might have been in the wrong hands.

[Pinkber]

Hi,

Not sure if you're all still checking this - but I can offer advice and also would like some. I had a ski accident at the end of March this year (some 9 months ago) and fractured the humurus head of my right arm. I have a plate and screws which looks very similar to the attached x-rays below. I had very, very restricted movement for a long time and only now is my arm starting to behave normally, although I still get pain and don't have 100% range of movement.

My question is whether it's ususal for the plate to come out. I'm getting mixed opinions on this. One consultant said yes, the other said no! What's ususal? I'm a 32 yr old female.

Grateful for any thoughts/advice.

Thanks!

Pinkber