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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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