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Proximal Humerus Fracture Open Reduction Internal Fixation

Post-Operative Instructions and Home Exercise Program

Things to Remember

  • DO NOT put any weight through your surgical arm.
    • Do not push yourself up with your surgical arm.
    • Do not lie on your surgical shoulder or roll onto that side.
    • Do not lift objects with your surgical arm.
  • DO NOT move your surgical shoulder.
    • Keep your arm in the slingthat was provided to you.
      • You can fold down the outer sleeve when you do your exercises.
      • You can remove the sling to take a shower (unless stated differently by your surgeon). Be sure to keep your arm still and close to your body.
  • DO perform your exercises 3-4 times aday, 10-15 times each.
  • DO use your ice for 15-20 minutes after doing your exercises to decrease swelling and pain.
  • DO perform your daily activities using strategies that your Occupational Therapist taught you.


  • Take 1-2 tablets every 4-6 hours as needed for pain.
    • Oxycodone 5-10mg every 4 hours as needed for pain.
    • Colace 100mg twice a day while on narcotics
    • Tylenol 650mg every 6 hours as needed for pain. (Use as directed)
  • Use your medicine liberally over the first 3-5 days, and then you can begin to taper your use. Do not take additional Tylenol if you are taking Percocet, Norco, or Vicodin. It is OK to take Tylenol with the Oxycodone.
  • DO NOT take ANY nonsteroidal anti-inflammatory pain medications: Advil, Motrin, Ibuprofen, Aleve, Naproxen, or Naprosyn.
  • Resume your home medications
  • You have been given a prescription for a stool softener, Colace. This medication is routinely used as pain medicines can be very constipating. Please take as directed unless you experience loose stools or diarrhea.
  • Aspirin has been prescribed to prevent blood clots. Take one 325mg tablet once a day for 6 weeks. If Coumadin or Warfarin is prescribed for blood clot prevention, take this medication as directed by your medical clearance physician. A nurse will come to your home and draw your blood to check your Coumadin levels. DO NOT TAKE COUMADIN AND ASPIRIN.
  • Other


  • Resume a regular diet as soon as possible. It is advisable to start with clear liquids until nausea is gone.

Sling / Brace

  • Use the sling / brace until your next office visit.
  • Remove the sling / brace to allow your arm and elbow to straighten at your side 3-4 times a day for 15-20 minutes at a time.


  • Increase your general activity level as the effects of the anesthetic medications have worn off and your strength improves.
  • Remain in your shoulder sling or brace as instructed above. This includes sleeping in your sling.
  • Place a pillow behind the elbow when resting either reclined or flat, this generally helps with shoulder pain.


  • The clear plastic dressing over the incision stays in place until your follow up appointment in 2 weeks, it is waterproof and you can shower over this and pat it dry. DO NOT REMOVE THE CLEAR PLASTIC DRESSING.
  • Bruising of the shoulder and the upper arm are common after surgery, even arthroscopic surgery.

Follow Up

  • Generally, a follow up appointment has been made for you at the time of surgery. You can call the office to confirm your appointment for 10-14 daysafter surgery. Notify our office at 781-890-2133 or 617-264-1100 if you have any of the following:
    • Fever over 101.5 degrees.
    • Excessive blood on your dressing.
    • Numbness or tingling in your arm or hand that was not present before surgery and has lasted more than 24 hours.
    • Drainage from any incision that last longer than 4 days following surgery.


Do the following exercises while lying on your back unless you were told differently.

**Undo the outer sleeve of your sling.

1. Hand - Bend fingers to make a tight fist, then straighten fingers completely.

Hand - Bend fingers
straighten fingers

2. Wrist - Bend hand downward, then upward.

Bend hand downward, then upward

3. Forearm - Rotate forearm so palm is up, then down.

Rotate forearm so palm is up
Rotate forearm so palm is down.

4. Elbow - Bend, then straighten completely.

Elbow - Bend

**Exercises 1 - 4 are done actively, 3-4 times a day, 10-15 repetitions.

**Reconnect sling after completing exercises.

  • American Academy of Orthopaedic Surgeons
American Shoulder and Elbow Surgeons
  • New England Shoulder and Elbow Society
  • Boston Sports & Shoulder Center
  • Tufts University