Clavicle ORIF

POST OPERATIVE MANAGEMENT :

• Remain in arm sling for first 6 weeks post-op
• Do not elevate surgical arm above 90° in any plane for first 4 weeks post-op
• Do not lift any objects over 5 pounds with the surgical arm for first 6 weeks post-op
• Avoid repeated reaching for the first 6 weeks
• Cryotherapy (ice machine, ice bags) 3-5 times/day for swelling, inflammation, and pain control Maintain good upright shoulder girdle posture at all times and during sling use

Week 1 :

• Pendulum swings
• squeeze ball
• triceps with Thera band
• isometric rotator cuff external and internal rotations with arm at side
• isometric shoulder abduction, adduction, extension and flexion with arm at side.
• Soft-tissue treatments for associated shoulder and neck musculature for comfort.
• Cardiovascular training such as stationary bike throughout rehabilitation period.

Weeks 2 – 6 :

• Soft-tissue treatments for associated shoulder and neck musculature for comfort.
• Gentle pulley for shoulder ROM 2x/day.
• Elbow pivots PNF, wrist PNF.
• Isometric scapular PNF, mid-range.
• Strive for progressive gains to active 90 degrees of shoulder flexion and abduction (though not beyond 90 degrees).

Weeks 6 – 8 :

• Start mid-range of motion rotator cuff external and internal rotations
• Active and light resistance exercises (through 75% of ROM as patient’s symptoms permit) without shoulder elevation and avoiding extreme end ROM.

Weeks 8 – 12 :

• Full shoulder Active ROM in all planes.
• Increase manual mobilizations of soft tissue as well as glenohumeral and scapulothoracic joints for ROM.
• No repeated heavy resisted exercises or lifting until 3 months.

Weeks 12+ :

• Start a more aggressive strengthening program as tolerated.
• Increase the intensity of strength and functional training for gradual return to activities and sports.
• Return to specific sports is determined by the physical therapist through functional testing specific to the injury.