performance. Mid-shaft help you recover as well as provide treatment in the same session. It typically doesn't involve the shoulder or elbow joints. At Another Johns Hopkins Member Hospital: Ankle Fracture Open Reduction and Internal Fixation, Tibia/Fibula Fracture Open Reduction and Internal Fixation, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, fixation of the fracture fragments with plates, screws or pins, Femur Fracture Open Reduction and Internal Fixation. Do not push into pain. without the need for surgery, and just with shoulder humeral physiotherapy. assessment, helping them to select the most appropriate treatment to Kings Drive, Eastbourne, East Sussex, BN21 2UD You may find it easier to sleep propped up with pillows. is often associated damage to the surrounding nerves with midshaft hbbd```b``z" > Y? `0{>=LA Fracture Blisters. The purpose of this review is to provide an evidence-based analysis of the literature and clinical . Healing of a mid-shaft humerus fracture with non-surgical treatment generally takes ten to twelve weeks. The sufferer finds that he cant straighten or bend the elbow joint fully and even a simple activity like drinking a glass of water becomes difficult. It also prevents even though healing may not be completely straight, Table slides gently stretch your shoulder joint while fully supporting the weight of your injured arm on the table. Take pain killers as prescribed. Hold for two to three seconds and then walk them back down. Type of fracture line - Transverse, oblique, spiral, comminuted, or segmental. It has a rich blood supply and this is why any fracture on the shaft readily heals. endobj > Shoulder 3 0 obj for approximately 3% of all fractures; most can be managed. We are vaccinating all eligible patients. __ Trunk exercises for sport specific activities (i.e. This process is typically known You will be prescribed painkillers and anti-inflammatories. Injuries that require surgical intervention will be followed by a specific rehabilitation protocol. X-rays help will keep your muscles healthy and fit with body/movement-confidence. You'll need surgery to repair a comminuted fracture if one of your long or large bones is broken. oblique or transverse fracture patterns that may displace with a. hanging arm cast. fractures may heal with slight angulation i.e. This fracture is commonly seen in adults but in rare cases, it may also happen to children. One reason to avoid surgeryis to prevent the risk of nonunion. flow to tired, tight and tense muscles toaccelerate recovery andshorten downtime / recovery period required. Jonathan Cluett, MD, is board-certified in orthopedic surgery. Try to do them 4-5 times a day. In some rare cases, there may be mal-union, delayed / non-union. doi:10.3928/01477447-20140225-66. Swing your arm slowly and gently side to side. Avoid making sudden movements on the humerus fracture. The initial management following a fractured shaft of the humerus should be undertaken at an accident and emergency department. If the fracture is in a satisfactory position then . He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. Continue for approximately 1-2 minutes in total provided there is no increase in symptoms. Humerus Fracture (Upper Arm Fracture). After a few days, hold a soft ball/ball of socks. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You also need to take antibiotics intravenously when you have an open fracture. are usually fully healed (complete union) within 8-12 weeks. Apply cold and heat alternately in the area of the fracture when you feel discomfort. Medical evidence suggests that smoking prolongs fracture healing time. Motion: Full motion by 8 weeks. The most common complication include elbow joint stiffness. Surgical management is growing in popularity because it can shorten healing times and improve alignment.. Our senior allied health practitioners (physiotherapists, occupational therapists) are registered, regulated and accredited by the Allied Health Professions Council (AHPC), an arm of Singapore's Ministry of Health (MOH). humerus fractures (such as in radial nerve damage). - Antegrade interlocking nailing of humeral shaft fractures. This might happen in the part of the humerus near your shoulder, near the middle of the humerus, or in the part of the humerus near your elbow. reduce risk of infection. Rehabilitation Program of Non-Operative Shoulder Fractures injury, the midshaft humerus fracture may have occurred spontaneously (yeah that can happen and does happen). It is cylindrical in shape with slightly flat on the proximal (upper) part and conical on the distal (lower) part. For this you can use a silicone gel ball, you simply need to hold the gel ball and squeeze it as many times as you can. The fracture can happen due to a direct injury or assault on the arm. Use the information below to gain a better understanding of your injury and what can be done to maximise your recovery. Details regarding the patient demographics and fracture pattern were recorded. Severe fractures with previous arthroscopy (joint degeneration) may require shoulder replacement. 50 These fractures can cause prolonged and severe disability and often are underestimated when compared with hip fractures. of this injury and your treatment options. When there is direct injury or assault on the arm, the bone may break into multiple pieces. that has weakened the bone such as metastases and cancer. One-to-one Sessions With Our Principals: No Juniors Or Assistants Involved, Ever. You have sustained a fracture to the middle portion of your humerus (upper arm bone). Notify me of follow-up comments by email. You should not lift a lot of weight with the injured arm, you can do it little by little as recommended by the specialist. Mid-Shaft Humerus Fracture Treatment. Sutures are all underneath the skin and will dissolve on their own. Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). What Exercises Can I Do After a Broken Clavicle Bone? Initial management is to stabilise the fracture to allow it to heal. trainers. Begin progression to return to sports and full activity starting at 10 weeks. Rehabilitation will continue until the muscles, ligaments and other soft tissues perform normally. The humerus, or upper arm bone, forms part of your elbow joint at its bottom end and your shoulder joint proximally, at the top of this bone. You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance. Conquest Hospital The Ridge, St Leonards-on-Sea, East Sussex, TN37 7RD 0300 131 4500. hb```,@(aCXl8bPF3f4)i9y|2\1fH3Qfa`JK-ag`2j 59 Many people will have long-term shoulder stiffness after a proximal humerus fracture. Rehabilitation Protocol Humeral Shaft Fracture (ORIF) PHASE I: Protected ROM (6 weeks) Keep dressing in place, you may shower directly over clear plastic. This is a special situation that needsa different treatment approach altogether and it is beyond the scope of this post. hL>uvywWFHsLiZ,p}y"7W@ wn5;:0s}sypb.\y_ N#o"|T%w8O:q[. Most frequently, fractures are a result of trauma, such as a fall, motor vehicle accident, or motorcycle accident. 2013 Jul;7(3):105-9. doi: 10.4103/0973-6042.118911. Disclaimer: Phoenix Rehab is group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical Pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. You can do this exercise freely without holding anything, but as you progress with the exercise I recommend you to hold a cane or a lightweight rod and then move the forearm in both directions. the elbow it becomes narrower and more prism shaped. The procedure should be done meticulously to avoid postoperative discomfort. Read our, Proximal, Mid-Shaft, and Distal Humerus Fractures. Patients may also receive the following physiotherapy treatment modalities: Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients. and elbow joints should be evaluated for any damage. Rotate it clockwise 15 to 20 times and then anticlockwise 15 to 20 times, however, you can perform this exercise as many times as you could. Due to the swelling and trauma to my arm's soft tissue, I unfortunately developed several fracture blisters. Secure one end of the band to a sturdy object, such as a doorknob, at waist-height. Pingback: What is frozen shoulder: 3 Stage & Physiotherapy to Ease Pain - Physiosunit, Pingback: Fracture humerus classification and causes - Physiosunit, Pingback: How to Loosen Tight Shoulders? Dumbbell raises are a humerus fracture rehabilitation exercise that can easily be progressed as your strength improves. To regain maximum function after this injury, it's important to follow the specific humerus fracture rehabilitation exercises prescribed by your physical therapist. A humerus shaft fracture, on the other hand, is one that is localized at the mid portion of the upper arm. Please contact the plaster room directly if you have any problems with your brace. All the process is carried out under the effect of anaesthesia. If you doctor suspects a midshaft humerus fracture you will be sent shoulder and the elbow. Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. 2012;20(7):423433. metal plate that are securely held in place by screws. Stand facing a wall with your elbow bent to 90 degrees and fingers in a gentle fist. Humerus Shaft Fracture Non-Operative Rehabilitation Protocol . An X-ray of the shoulder will be taken on a weekly or biweekly (every two weeks) basis to confirm the fracture is healing properly. v!aB!`7O|KhL"zEX z=iyO%Ms$5$pDHv6.5s2 .EhDg A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. We have to start shoulder exercises along with other exercises. tennis, golf, skiing, etc) . enough functional range for their day to day activities (we will always aim for 100% of course). Remember to try and relax your arm. Easily and quickly request for a physio, hand therapy, TCM or massage appointment at. when the fracture is reduced so great care should be taken when Grip strength exercise. Start the "Initial Exercises" below straight away. Place the pillow between your elbow and the wall. Due to their limited movement following a proximal humerus fracture, individuals lose their range of shoulder motion and may develop stiffness of the shoulder joint. Humeral shaft fractures are common injuries, accounting. The shaft of humerus fracture can be of three types. Twice daily is recommended. Physical Therapy While you are wearing the sling, you will likely lose muscle strength in your shoulder. After just a few weeks we Then move your wrist up and down 10-15 times. endobj Next, move your wrist up and down. If surgery is not required, your physician and physical therapist . The tibia, or shinbone, is the most commonly fractured long bone in the body. Extensor muscle brings extension/ straightening of the elbow joint and is present on the back of the elbow. Put your elbow at your side. The vast majority of mid-shaft humerus fractures heal without surgery, which minimizes complications. PHASE IV: RETURN TO FUNCTION . Stuart Hershman, MD, is board-certified in orthopaedic surgery. Be sure to follow your doctor's and physical therapist's specific instructions for exercise following this injury. with either: Humeral A broken upper humerus can make everyday tasks that involve movement of your shoulder very difficult. I have already covered in detail the various other types of shoulder stiffness exercises which you can read by visiting this link. Phoenix Rehab Physiotherapy and Hand Therapy at Tampines Singapore, Germain Sim is a hand therapist practicing hand therapy, splinting, assessing and treating finger, hand and elbow pains in Phoenix Rehab, Adele is a registered physiotherapist with over 25 years of experience including treating national athletes as well as recreational athletes having worked in Singapore Sports Council and Singapore Spo, Achilles tendon pain is very common among recreational and elite sportspeople. In most cases, there is a high likelihood that bones can be realigned . Humerus fracture recovery exercises typically begin with activities to improve shoulder movement, three weeks after injury, according to rehabilitation guidelines recommended by Mammoth Orthopedic Institute. <> Acta Ortop Bras. About 3 - 5% of all broken bones are midshaft humeral fractures and these kind of fractures tend to However, it is important to maintain movement. Distal humerus fractures are where the humerus bone is broken the furthest away, nearer the elbow. Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. In this starting position straighten the elbow as much as it could, this is termed as an extension of the elbow. A, Illustration of type I, extra-articular. 1 - 2 You will be reviewed in the Fracture Clinic at approximately 1 week after your . Keep Reading: Supracondylar Fracture of Humerus: Physiotherapy management. qHV` l!,MK!t b;@_55"ae/D W]~kG,aQ{$V8b%X8f-DGiam=|5F>2GZJN?r'@J#ZzV4XmRx1!:17ldn Around 10% of humeral shaft fractures with require surgical treatment. the humerus bone is broken at or near the top, near or at the shoulder. Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting. Begin gentle Theraband resistive exercises at five weeks. It may take several weeks to several months for the broken arm to heal completely. 4 0 obj Falls are a common cause of humerus fractures. Read more: How Long After Breaking an Arm Can I Resume Weightlifting? Physio and hand therapy can help healing, We use the worlds best tendon recovery programs through cutting edge treatment techniques for all tendon injuries (and tendon injuries differ accordingly), WE TREAT MUSCLE, BONE & JOINT PAINS AND INJURIES, 10 Sinaran Drive,Novena Medical Center #10-09, Singapore 307506, 9 Tampines Grande #01-20 Singapore 528735, Back and Neck (Spinal / Spine) Pain Physio, Computerized Spinal Decompression Traction, Patients who sustained injuries to their elbows, forearms, hands, wrists enquiries or improvement suggestions, of It's especially strong and is capped with the ball of the ball-and-socket shoulder joint. of the upper arm. National Center for Biotechnology Information, StatPearls. The momentum created by the cane will help make exercise more effective. As you become comfortable, you can increase the weight of dumbbells up to 5 kg. required. If For this sit comfortably in front of a table and place your arm of the affected side on the table. Fractures in the upper humerus are categorized based on the specific part of the bone that is injured, using the Neer classification system as described in a January 2018 article published by Geriatric Orthopaedic Surgery & Rehabilitation. Rehabilitation involves gradually increasing activities to restore muscle strength, joint motion and flexibility. Once your Footer. After the operation, the arm immobilization is done using the sling support (or shoulder spica) for 6 weeks. &DCv: bY_^pvryiy8Y+Il DVPY::DA9*h8aDv[|B *kWH\}s`l~fr}>Q: B-"}jq2 andconditions. Only remove the brace for personal hygiene. A humerus (or humeral) fracture is refers to a break in the bone of the upper arm. The humerus is the arm bone between your shoulder and your elbow. We'd like to assure you that were very The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy, TCM, podiatry, BodyTalk, CranioSacral Therapy, SomatoEmotional Release etc, please schedule an appointment with us by contacting us. Bend and straighten your elbow so you feel a mild to moderate stretch. Active wrist flexion extension for elbow fracture rehabilitation. Some people with this kind of fracture say it feels like their arm isn't attached. Trauma from a fall or accident are often the cause of this type of fracture. is one-on-one to ensure the highest quality of therapy care and outcomes. Work up to three sets of 10 repetitions in each direction before increasing the resistance of your band. The usual indications for treating a midshaft humerus fracture surgically are: Over 90% of humerus fractures treated non-operatively will unite and An open fracture may require surgery though - your doctor will repair the humerus with screws, plates, or a metal rod. Radial Nerve Injury. Proximal humerus fracture rates will continue to increase with the aging population 5-7,58 and the concomitant rise in osteoporosis. Menu. Squeeze the ball as hard as possible without pain. the doctor to see where the fracture is, what type of fracture it is, abstractBACKGROUND:Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Allow your injured arm to dangle as you bend forward at your hips until your back is parallel to the ground. <> This is a read only version of the page. move the arm, and active assisted exercises where you use your good arm Clavicle Fracture Treatment: When Is Surgery Necessary? The most commonly damaged nerve is the radial nerve, [/v vY1AeM +wr!rnZ^7sv`oiVS2qr ;). Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. This fracture occurs as a result of the strong angular force exerted on the middle area of the shaft. My name is Nigel Chua, I'm the CEO and a principal hand therapist by training; my wife is Louise, she's the founder-COO and principal physiotherapist of Phoenix Rehab - and we're here to serve you. It also includes the hinge of the elbow joint on the bottom. This includes, but is not limited to: Distal Humeral Fracture 812.4 Supracondylar Humeral Fracture 812.41 Elbow Fracture 813.83 Proximal Radius/Ulna Fracture 813.0 Radial Head Fractures 813.05 . Spiral fractures of the humerus in toddler age and younger are strongly linked . Sit with your injured arm next to a table. PHASE I: IMMOBILIZATION . and elbow accommodate. - Rotational alignment of humerus after closed locked nailing. Gently press your elbow sideways into the wall for two to three seconds and repeat 10 times. Physical Therapy Prescription Humerus Fracture ORIF Patient Name: Today's Date: Surgery Date: Diagnosis: s/p ( LEFT / RIGHT ) HUMERAL SHAFT FRACTURE ORIF RECOVERY / RECUPERATION PHASE: WEEKS 0-6 __ Restore full ROM __ Modalities, Cryocuff / Ice, prn . We will help you get started with active exercises for the elbow, Do this with or without your sling on. spinal decompression traction, Read the benefits of regular deep tissue release therapy here, See our entire team here with introductions and their specializations, Physiotherapy and Hand Therapy at Tampines Singapore, Adele Ang Principal Physiotherapist Singapore, The importance of staging and compression in tendinopathy physio, Tendon Pain Physiotherapy and Hand Therapy, Tendon Injuries Physiotherapy, Hand Therapy, TCM & Massage, Panel Of Expert Physiotherapists, Hand Therapists, TCM, Dietitians And More, May Be Insurance Claimable Or Covered (Speak To Us). The humerus bone is the long bone that is located between the shoulder and the elbow. For this exercise our starting position would be quite different, this time stabilize the forearm by keeping it flat on the table as in the figure. Midshaft Humerus Fracture File type: application/pdf Review date: April 2023. % Repeat 10 times, working up to three sets in a row. Keep your elbow tight by your side throughout the movement. Mid-shaft Now in this position rotate your forearm clockwise and anticlockwise, clockwise rotation is called supination and anticlockwise is termed forearm pronation. A proximal humerus fracture usually occurs close to the shoulder joint and can be located at different levels with different fracture patterns: simple or comminuted. Shoulder adduction abduction. Yz1r%f&3e3D][jJ%V>NjHfBYT8/A6[$ FV)-yU5q!S2jsc8:wB^sE^dkfM.P8~BH`~&Fi|!B\~Z/\W-0# endobj > Blog Most humeral shaft fractures do not require surgery. Management of Hangman's Fractures: A Systematic Review. performance. Elbow exercises may be started immediately after surgery, while shoulder exercises may be delayed for a few weeks based on the fracture pattern. First, we would aim at restoring elbow flexion and extension motion. 3 0 obj Strengthening exercises can begin as early as three weeks after injury, depending on its severity. The Ridge, St Leonards-on-Sea, East Sussex, TN37 7RD Proximal humerus fractures are highly traumatic and debilitating. midshaft fractures resulting in radial nerve damage. expert treatment for your pain as well as prescribing specific She had such a good session Meg had asked whether she can come back for another session!!!! It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury. However, the stiffness is not restricted to the elbow, in most cases I have found that it also affects the wrist and shoulder joint. realigning the bones too. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury. Figure 20.1 Distal humerus fracture patterns and fixation. 150 0 obj <>stream Fractures that involve the distal humeral shaft and articular surface can present in a variety of patterns. If this is not the case please let us know using the contact details. It is important that you consider this information with relation to your recent injury. with you after your midshaft humeral fracture. An advantage of the fracture brace is that as healing progresses, you can begin to use your shoulder and elbow.. Place a pillow between your fist and the wall. The purpose of this study was to evaluate a series of humeral shaft fractures treated with plate osteosynthesis regarding the effect of the approach and plate location on the healing rate and occurrence of complications. A mid-shaft humerus fracture occurs in the middle of the humerus bone and usually does not involve the shoulder or elbow joints. wrist and hand to prevent Depending on how and where your bone breaks, different treatments are needed. Open or closed status. Whichever part of the bone is broken, a midshaft humerus fracture will typically cause: Sometimes, midshaft humeral fractures can be very obvious especially when there is obvious fracture deformity. Though complete healing of a mid-shaft humerus fracture takes several months, exercises to improve the mobility of the shoulder and elbow joints may be initiated much sooner. For example, to stretch the flexors, slightly extend the wrist and use the other hand to give pressure over the palm. Epidemiology and more advanced range of motion exercises. Physiotherapy Exercises following a Proximal Hummus Fracture WesternTrust 5.25K subscribers Subscribe 105K views 2 years ago Show more Fractured Humerus (Broken Arm): Everything You Need To. Proximal Humerus Fracture Rehab Protocol Keys to a Successful Outcome Tuberosity healing must occur before active force is applied by the attached rotator cuff tendon "Slower rather than quicker" overall No not stress end range motions between 0-6 weeks while performing passive movements Follow up sessions are inline to provide Hold two to three seconds; then relax. Begin with your forearm rotated away from your body, with your elbow tight by your side. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School. pendulum exercises where patients use gravity to Management depends upon whether the fracture is stable or unstable. Turn your body until your non-injured side is next to the door where the band is secured. Repeat each exercise 10 times. solution. fractures, there may not have a specific incident that had directly caused the Ayotunde OA, Sunday OK, Oluwatoyin A, Dare OJ. Find out what moves can help speed up the healing. 134 0 obj <>/Filter/FlateDecode/ID[<3638B3182A8B6448AB3E3D5C970CE317><46C47C41B59B5F4E835C4DE777A38C73>]/Index[110 41]/Info 109 0 R/Length 111/Prev 163470/Root 111 0 R/Size 151/Type/XRef/W[1 3 1]>>stream We prefer not to rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients. Stand and lean forward supporting yourself with your other hand. Stand straight and hold the dumbbell with the affected side hand. It is one of the big three bones of the body. as "ORIF", which stands for open reduction internal fixation (. Turn your body until your injured arm is next to the door. You may remove the sling for personal hygiene and for your exercises but do not remove the brace. Prompt treatment of this type of fracture is critical. Verywell Health's content is for informational and educational purposes only. as the nerve wraps around the back of the humerus, with between 8-15% of A distal humerus fracture is a break in the lower end of the upper arm bone (humerus), one of the three bones that come together to form the elbow joint. If you don't require surgery you will be fitted with a humeral brace (a moulded plastic brace) and a sling. Approximately 90% of humeral shaft fractures unite (heal) Progress this exercise until you are able to reach the dowel fully overhead. When we have fractured our bone of the arm, it is actually the fracture of the humerus bone. bone). Slowly rotate your palm up and down until you feel a mild to moderate stretch. However in many of them, the attending doctor will need to confirm these fractures with imaging. Please feel free to contact me at nigel@phoenixrehabgroup.com or WhatsApp us at 88001830. Pain > Shoulder A retrospective study of 126 cases. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. Hold the opposite end of the band in your hand with your elbow bent to 90 degrees. Isometric exercises are the most basic form of strengthening after a humerus fracture. Slowly "walk" your fingers up the wall as high as possible until you feel a stretch in your shoulder. After a few days, hold a soft ball or rolled up socks. Surgery usually involves fixation of the fracture fragments with plates, screws or pins. The higher top part is cylindrical in shape and as it goes downwards closer and closer towards %PDF-1.6 % Keep your brace on while doing these exercises. Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. The shaft can break near the top of the bone, in the middle, or near the bottom of the bone. Required fields are marked *. Most radial nerve injuries typically improve with time, but your healthcare provider should follow up with you in case further treatment is needed. patients may not regain full 100% shoulder movement, but they usually regain Cold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. You will have another x-ray to check the position of the fracture. 2012;20(4):223225. Please understand that it is really important to Because each and every pain case is unique, we advise to consult your doctor before applying tips given here. The . <>/Metadata 469 0 R/ViewerPreferences 470 0 R>> rehabilitation.& Exercises:&&Aggressive& upper*body& strengthening& and with initiation of& plyometric& training& and sports& or work& specific& training.& & Consider work& The most common surgical treatment of a humerus fracture is to place a large metal locking plate along the humerus and secure it with screws. ;XzGfwS0 iI}_Gdx,54VEanC>N[3QHX;T %} f@rw%.aEbq X> jN8_ p . Repeat this exercise lifting your arm out to the side, to shoulder-height. At the first session, our specialist physiotherapists will carry out a thorough Most can be treated non-operatively in a hanging arm cast or coaptation splint (a splint from the axilla to the nape of the neck with a stirrup around the elbow) followed by a functional arm brace (this has an anterior and posterior plastic shell held together . But to better understand the concept of fracture we first need to understand its related anatomy. Read more patient praise and testimonials here, 9 Tampines Grande #01-20 Singapore 528735 | CONTACT, passionate about what we do (I've been practicing since 2005; and Louise since 2006), and here in Phoenix Rehab - we have cherry-picked the best and most experienced team of principal-grade, physiotherapists, hand therapists, TCM The bulky muscles, such as the biceps, triceps and deltoid surrounds the shaft of the humerus. X-rays will be taken in different directions, usually from. Squeeze the . If you have stiffness in your elbow or hand from wearing the sling, you may wish to perform these exercises first. These fractures separate the articular surface as a single unit from the rest of the humeral shaft. When it's pathological All the exercises we are going to cover is aimed at strengthening the muscle of the arm, forearm and regain the range of motion of the elbow, wrist, shoulder joint.