Stemmed Hemiarthroplasty for Fracture

Stemmed hemiarthroplasty for fracture, suggested rehabilitation.

Post op: Day 1

Mastersling with body belt fitted in theatre
Cryocuff to reduce inflammation
Finger, wrist and radio ulnar movements
Active assisted elbow flexion and extension
Teach axillary hygiene
Hand gripping exercises
Shoulder girdle exercises and postural awareness Continue the exercises above for 3 weeks at which time the patient will be reviewed at The Shoulder Unit.

3 Weeks

Body belt removed
Commence pendular exercises
Continue with shoulder girdle exercises, postural awareness and include scapular setting

6 Weeks

Gradually discard sling
As pain allows progress to full passive range of movement
Add active assisted progressing to active exercises
Introduce anterior deltoid strengthening exercises as appropriate
Isometric strengthening of all groups and progress to isotonic, as the patient is able
Can begin hydrotherapy where available
Can encourage the patient to move through all ranges with attention to self-stretching at end of range
Proprioceptive exercises and core stability work as required

Return to Functional Activities : (earliest recommendations)

Driving 8 weeks (dependent on ease of movement and safety)
Swimming
8 weeks for breaststroke,
freestyle will take longer
Golf - 3 months
Light lifting can begin at 8 weeks. Avoid lifting heavy items for 6 months
Return to work - The patient should be guided by the surgeon.
N.B. The protocol for a shoulder replacement following a fracture is less aggressive than that of the Copeland Shoulder Replacement due to the bony injury and the need to protect the healing of the tuberosities. Active movement is delayed to allow for bony union. Progression will be slower. Use pain and the patient’s ability as your guide.
Please check with the relevant Consultant for individual variances to the protocol.