Distal Humerus Fracture Rehab Protocol

Keys to a Successful Outcome

  • Brace should be worn as instructed to allow the surgical elbow to heal accordingly.

  • Absolutely no aggressive or forced rotation during the initial rehabilitation phases.

  • Complying with non-weight bearing orders until at least six weeks post-op.

Phase
Brace/Sling
ROM
WB
Exercises
Weeks 1-4
Wear at all times for 1 week and then wear only when outside for 3 more weeks.
Passive flexion and ABD to 90°, ER as tolerated at 0° ABD, IR to as tolerated.
NWB
Cervical ROM exercises; elbow, wrist, hand ROM; Active elbow flexion/extension; shoulder shrugs and scapula retraction; wall walking or table slides for flexion and abduction (all to as tolerated).
Weeks 4-6
Discontinue the sling at week 4 but can be worn for comfort if desired.
As tolerated in all planes. No aggressive or forced passive ROM until full union of fracture
NWB
Begin no-load serratus exercises at 5-6 weeks; Begin limited range, no resisted active ER/IR with towel roll; sub maximal isometrics as tolerated.
Weeks 6-9
Not needed
As tolerated in all planes.
PWB
Begin posterior capsule stretches; begin UBE, below shoulder level; progressive scapular strengthening; begin rows with theraband; begin light band theraband resistance exercises in all planes.
Weeks 9-12
Not needed
Continue working towards FAROM
PWB
Increase resistance with theraband exercises; advance kinesthetic awareness exercise to multi-angle; CKC progression of UE muscles.
Months 3-6
Not needed
FAROM
WBAT
Advance strengthening for rotator cuff and rest of the UE; advance scapular exercises; no overhead lifting for 4-6 months post-op; sport-specific training.

 

*May remove for hygiene and exercises

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