Fractured Humerus Fixation

Fixation of a Fractured Humerus

Fractured humerus fixation surgery is a widely used procedure when the upper part of the arm bone (proximal humerus) is broken. Proximal humeral fractures are commonly classified using Neer’s classification, which identifies four key regions:

  • The humeral head
  • The greater tubercle
  • The lesser tubercle
  • The surgical neck

These injuries are often seen in older adults, with the most frequent cause being a fall onto an outstretched hand or direct trauma to the shoulder. In many cases, non-displaced fractures can be managed conservatively with a supportive sling and guided rehabilitation. However, if the fracture is displaced and the bone ends are separated, surgical fixation is usually recommended to realign and stabilise the humerus.

Surgical Options for Humerus Fixation

The choice of surgical treatment depends on factors such as the severity of the fracture, the patient’s age, general health, and the time elapsed since injury. Common surgical methods include:

  • Open Reduction and Internal Fixation (ORIF): The fractured bone fragments are repositioned and secured using a plate and screws.
  • Humeral Head Replacement: Typically performed in complex 4-part fractures, often involving shoulder hemiarthroplasty.

Because the rotator cuff muscles attach to the proximal humerus, these fractures can significantly affect shoulder stability and function. If these muscles are damaged, surgical repair and structured physiotherapy are essential to restore normal movement, strength, and functional use of the arm.

At acephysiosports.com, a tailored rehabilitation programme will guide recovery, focusing on pain relief, restoring mobility, and gradually rebuilding strength and stability for a safe return to daily activities and long-term function.

Physiotherapy Prior to Fixation of a Fractured Humerus

Physiotherapy before humerus fixation surgery is highly recommended as it helps control immediate symptoms and prepares the shoulder for optimal recovery after surgery. By addressing pain, stiffness, and muscular weakness early, you create a strong foundation for post-operative rehabilitation. Early physiotherapy not only speeds up recovery but also maximises your long-term functional outcome.

  • Cryotherapy for pain and swelling control
  • Pain management strategies
  • Protective taping and bracing
  • Acute symptom management
  • Strengthening of surrounding muscles
  • Guidance on surgery and post-surgical rehabilitation

Symptoms Following Fixation of a Fractured Humerus

After humerus fixation surgery, your arm will be placed in a protective sling to support healing and reduce stress on the repair. During this period, arm use will be limited, and you may experience common post-operative symptoms such as:

  • Pain around the surgical site
  • Shoulder stiffness and reduced mobility
  • Bruising and swelling
  • Weakness in surrounding muscles
  • Neurological changes (numbness, tingling, or weakness) due to the proximity of nerves to the humerus

Physiotherapy After Fixation of a Fractured Humerus

A structured physiotherapy programme is essential for recovery after humerus fixation. At Physio.co.uk, we provide personalised assessments, set realistic goals, and design progressive treatment plans to restore shoulder strength, stability, and function. Rehabilitation will begin with acute symptom management and gradually progress to functional and sport-specific training.

Weeks 1–3: Early Recovery

The focus is on protecting the surgical repair, managing pain, and beginning safe movements. Treatment may include:

  • Cryotherapy and pain relief
  • Sling management
  • Active mobility for elbow, wrist, and hand
  • Gentle strengthening for distal joints
  • Passive shoulder range of motion
  • Postural awareness and scapular setting
  • Wound care and patient education

Weeks 4–6: Regaining Motion

As healing progresses, the sling is reduced, and shoulder mobility and strength exercises begin. Treatment may include:

  • Increased passive range of motion
  • Active-assisted and active shoulder movements
  • Isometric strengthening of shoulder muscles
  • Scapular stabilisation
  • Joint mobilisations
  • Proprioceptive training
  • Nerve gliding (neurological mobilisations)
  • Scar management

Weeks 7–12: Functional Rehabilitation

Rehabilitation intensifies with the aim of restoring full mobility, strength, and endurance. Treatment may include:

  • Full range of active and passive movements
  • Rotator cuff strengthening
  • Stretching and soft tissue release
  • Endurance training for shoulder muscles
  • Advanced proprioceptive and balance exercises
  • Functional activity retraining

Weeks 12+: Advanced Strength and Function

By this stage, mobility and strength are close to pre-injury levels, though complete recovery may take up to 12 months. Long-term physiotherapy ensures safe reintegration into work, recreation, and sport. Treatment may include:

  • Full range of motion restoration
  • Advanced strengthening across all planes
  • High-level proprioceptive drills
  • Functional and task-specific retraining
  • Long-term home exercise programme
  • Ongoing management and injury prevention strategies

Summary

Fixation of a fractured humerus is a surgical procedure performed to realign and stabilise the arm bone following severe injury. Since the humerus is a key site of muscle attachment and lies close to major nerves, fractures in this area can cause significant functional problems if not properly treated. Physiotherapy is a vital part of recovery, ensuring pain management, restoration of movement, strengthening of the rotator cuff and surrounding muscles, and safe return to daily and sporting activities. At Physio.co.uk, our goal is to help you achieve complete functional recovery and long-term shoulder health.

To arrange an assessment with AcephysioSports.com, please contact us or call +65 8153 5374. Alternatively, you can book an appointment online today!

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