In both conservative and surgical management the immobilization is done for certain weeks. corporate or group collaborations / pricing etc, Finger, Wrist, Forearm & Elbow Conditions, Conditions By Body Part Affected / Location, Finger, Hand, Wrist, Forearm & Elbow Conditions, Physio May Be Insurance-Covered (Must Read), Back And Neck Pain Physiotherapy (Spinal), INDIBA Activ ProRecovery System Physiotherapy, Ergonomics & Repetitive Strain Injury Prevention, Back Rest Cradle Molded Lumbar Cushion Singapore, Health Supplements For Quicker Bone & Injury Healing, Skinception Skin Care, Scar And Hair Removal Products, computerized Rehabilitation Program of Non-Operative Shoulder Fractures The entire length of the humerus bone is included in the splint. In a shaft of humerus fracture case, immediately after the removal of plaster cast the most important secondary complication is elbow joint stiffness. You can use your other arm to assist if necessary. Read the benefits of regular deep tissue release therapy here. Details regarding the patient demographics and fracture pattern were recorded. Keep the arms flat on the table to make a good base of support to perform elbow exercise. The fracture can happen due to a direct injury or assault on the arm. Some people with this kind of fracture say it feels like their arm isn't attached. Jonathan Cluett, MD, is board-certified in orthopedic surgery. is one-on-one to ensure the highest quality of therapy care and outcomes. This website is for information purpose only and not a replacement of actual doctor consultation. X-rays help A temporary splint extending from the shoulder to the forearm and holding the elbow bent at 90 degrees can be used for initial management of the fracture. holding the humerus in place. Find more COVID-19 testing locations on Maryland.gov. "XnT!eW-a,k't`IJQGCK>L]_"TFAM;{C7"OF`o/r^&_Q#?=7mZ_Q~eEFzL5Y[67TL.zc1ZkT3(J{'D.q!6ag,nqtYAXw =4CABl6Vyh >/H6w [,ChDo4YcGX* J0la&I4G5;K 50 These fractures can cause prolonged and severe disability and often are underestimated when compared with hip fractures. A coaptation splint is a "U-shaped" splint that is placed under the axilla or arm-pit, wrapped around the elbow and terminating near the top of the shoulder. with either: Humeral In most cases, there is a high likelihood that bones can be realigned . The main aim of rehabilitation is to regain enough movement to return to your usual daily activities. Severe fractures with previous arthroscopy (joint degeneration) may require shoulder replacement. Conquest Hospital The Ridge, St Leonards-on-Sea, East Sussex, TN37 7RD 0300 131 4500. Lets start with the elbow joint which is the most affected joint. affect. After the fracture reduction, the immobilization of the arm is done for 6 to 8 weeks using one of the following ways. The splint is heavily padded. pendulum exercises where patients use gravity to Holliers Hill, Bexhill-on-Sea, East Sussex, TN40 2DZ <> You will have another x-ray to check the position of the fracture. 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. - proximal interlocking: - only lateral to medial placement is recommended for proximal interlocking screw; - be sure that screws are inserted above the level of the humeral neck (so . He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. need to be realigned and held in place. Humerus fracture recovery advice will vary somewhat, depending on the location and classification of your specific injury and your personal goals, according to a September 2013 article published by Deutsches Arzeblatt International. Shoulder stiffness can become problematic if not taken care of. Grip strength exercise. Repeat the same process to stretch the elbow extensors, but this time by bending the elbow. These fractures separate the articular surface as a single unit from the rest of the humeral shaft. Swing your arm slowly and gently in circles clockwise. Pain and pathology in a tendon, known as tendinopathy, is a common injury in athletes that can be difficult to manage. One indication for surgery is an inability to maintain the fracture in adequate alignment with. Passive FF while supine, gentle ER to neutral if comfortable, pendulum okay if comfortable, Elbow/wrist AROM, grip strength, scapula isometrics, no resistance exercises, AAROM>AROM as tolerated; PROM Goals: FF 120, ER 50, IR 50, Active FF 100, Begin active motion in plane of scapula, AAROM pulleys, sub-max pain-free isometrics in neutral, scapular strengthening, assisted horizontal Add, Progress AROM/PROM; AROM goals: FF 130 (scapular plane supine), ER 55, IR 60, Initiate assisted IR behind back stretch, resisted IR/ER in scapular plane, begin supine active elevation strengthening(i.e. %PDF-1.7 oblique or transverse fracture patterns that may displace with a. hanging arm cast. 0300 131 4500, Eastbourne District General Hospital reduce risk of infection. realigning the bones too. It is important that you have feeling in your hand and that you can wiggle your fingers. A broken upper humerus can make everyday tasks that involve movement of your shoulder very difficult. injury, the midshaft humerus fracture may have occurred spontaneously (yeah that can happen and does happen). 2 even though healing may not be completely straight, So, proper exercises are very crucial. Injuries that require surgical intervention will be followed by a specific rehabilitation protocol. In this resting position try to rotate your wrist joint. Let us start with stretching of elbow flexors, for this first straighten your elbow to the maximum. Take pain killers as prescribed. A humerus shaft fracture may be treated with or without surgery, depending on the fracture pattern and associated injuries (i.e., nerve injury or open fracture). Figure 20.1 Distal humerus fracture patterns and fixation. required. Bend and straighten your elbow so you feel a mild to moderate stretch. That is why immediately after the plaster cast is cut removed one should start exercises and physiotherapy as early as possible. Find out what moves can help speed up the healing. Hold two to three seconds and then slowly return to the starting position. Metal implants are not meant to be a long term <>>> While the specific exercise timeline might differ between individuals, humerus fracture recovery exercises follow a similar progression across fracture types. 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. After a few days, hold a soft ball or rolled up socks. No classification scheme for humeral shaft fractures has . rod/nail. Healing of a mid-shaft humerus fracture with non-surgical treatment generally takes ten to twelve weeks. Hold two to three seconds; then relax. Most frequently, fractures are a result of trauma, such as a fall, motor vehicle accident, or motorcycle accident. which part of the bone is broken. In one of our posts 3 Fracture Humerus Classification, Its Sub-Type Simplified we have seen that our arm can get fracture at three different sites. Exercises for Increased Shoulder Flexibility, Deutsches Arzteblatt International: "The Treatment of Proximal Humeral Fracture in Adults", American Physical Therapy Association: "Physical Therapist's Guide to Proximal Humerus Fractures", Geriatric Orthopaedic Surgery & Rehabilitation: "Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient", Mammoth Orthopedic Institute: "Rehabilitation Guidelines for Proximal Humerus Fracture (Non-Operative)". The most common site of fracture is at the junction of proximal 1/3rd and distal 2/3rd. The fracture makes a transverse pattern as shown in the figure. The patient is usually given a sling for comfort and arm support. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury. Keeping your forearm parallel to the ground, pull the band backward while squeezing your shoulder blade toward your spine. If Please contact the plaster room directly if you have any problems with your brace. > Shoulder Accelerate Your Healing & Recovery post-surgery and injuries. Stand with your non-injured arm supported on a counter or table. The humerus is the arm bone between your shoulder and your elbow. Injuries to the radial nerve are fairly common in a mid-shaft break because this important nerve tightly wraps around the middle of the humerus. under influence of gravity) to good alignment and apposition using a collar and cuff. shoulder and the elbow. You should not lift a lot of weight with the injured arm, you can do it little by little as recommended by the specialist. But it is also common among sedentary individuals, Tendonitis, tendinopathy and tendinosis are all tendon injuries and treated by physiotherapists and hand therapists, Cervical spondylosis is a general term to describe the degenerative condition in the neck which results in pain and other symptoms, Tendinopathy (tendon injuries) can develop in any tendon of the body and has many names such as tendinitis and it can be treated with good tendon physiotherapy. Most of the time, the humeral fracture is secured - Antegrade interlocking nailing of humeral shaft fractures. The humerus bone is the long bone that is located between the When it's pathological Symptoms vary depending on the specific type of fracture but may include: A grinding sensation when the shoulder is moved, Loss of normal use of the arm if a nerve injury occurs. If you don't require surgery you will be fitted with a humeral brace (a moulded plastic brace) and a sling. Surgery usually involves fixation of the fracture fragments with plates, screws or pins. (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to, Commonly treated hand pain injuries includes, REFORMER CLINICAL PILATES & WELLNESS PILATES. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Avoid loading shoulder at extreme ROM, progress with strengthening activities as tolerated. clinical experience, in-depth assessments, unrushed sessions and every session Without a functioning humerus you cannot position the hand in space or use the elbow. You have sustained a fracture to the middle portion of your humerus (upper arm bone). Often shoulder joint stiffness is ignored in such conditions. Slowly rotate your forearm away from your body, against the resistance of the band. If you still have significant pain and limitation after four to six months despite rehabilitation you [/v vY1AeM +wr!rnZ^7sv`oiVS2qr ;). endstream endobj 111 0 obj <. 2. 25 This will increase the demands on health providers further, and some suggest that society faces an epidemic of fractures in the elderly . Phase-3: Week 6 to 10. endstream endobj startxref Squeeze the ball as hard as possible without pain. If the upper arm bone (humerus) fractures into two or more pieces, the jagged ends can injure nearby nerves and blood vessels. Motion: Full motion by 8 weeks. and elbow accommodate. Appropriate. There 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. You can use your other arm to assist if necessary. hb```,@(aCXl8bPF3f4)i9y|2\1fH3Qfa`JK-ag`2j 59 . IM nails can be used to stabilise a humerus fracture that is Read more patient praise and testimonials here=), PHOENIX REHAB PHYSIOBack, Neck, Shoulder, Hip, Knee, Ankle & Hand Physiotherapy SpecialistsHome | Team | Conditions Treated | Therapy Products | Clinic Locations | Careers. . Hand, wrist and elbow exercises: 1. Keep it on for your exercises. The humerus goes from the shoulder joint to the elbow joint and must be strong enough to take a good deal of weight when you lift something or push against something. Usually, the fracture is treated in a splint or sling for a week to allow swelling to subside, and then you're fitted with a fracture brace. It does not replace the opinion, discussion, and treatment from a trained medical professional. The outcome was measured as patient satisfaction, return to activities, and need for further treatment at a minimum of one . Now in this position rotate your forearm clockwise and anticlockwise, clockwise rotation is called supination and anticlockwise is termed forearm pronation. You also need to take antibiotics intravenously when you have an open fracture. the shaft of humerus is bigger than the front part of the bone. It may take several weeks to several months for the broken arm to heal completely. A mid-shaft humerus fracture occurs when there is a direct blow to the upper arm. For example, to stretch the flexors, slightly extend the wrist and use the other hand to give pressure over the palm. An advantage of the fracture brace is that as healing progresses, you can begin to use your shoulder and elbow.. Slowly rotate your palm up and down until you feel a mild to moderate stretch. Due to the long-term immobilization, it is natural that the grip strength would be affected and it becomes weak. Repeat each exercise 10 times. Diagnosis is made with orthogonal radiographs of the humerus. At the first session, our specialist physiotherapists will carry out a thorough Though older The fracture needs to be immobilised to allow time for the bones to knit back together and heal. hbbd```b``z" > Y? `0{>=LA exercises to reduce your risk of re-injury and giving you a long term A coaptation splint is typically used for 7 to 10 days, until more definitive treatment is . These fractures can be caused by car accidents, sports. The radial nerve can be injured at the time of the fracture or during treatment. The humerus is the bone in the upper part of your arm. Kings Drive, Eastbourne, East Sussex, BN21 2UD So, this shoulder elevation exercise is a very simple, basic exercise. metal plate that are securely held in place by screws. the humerus bone is broken at or near the top, near or at the shoulder. Rehabilitation Protocol for Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF) . It typically doesn't involve the shoulder or elbow joints. It normally takes 9-12 weeks for this injury to heal. Be sure to follow your doctor's and physical therapist's specific instructions for exercise following this injury. Complications are more common with complex fractures and those requiring surgery, orthopedic surgeons will tend to be more conservative and try to prevent unnecessary surgeries. Nonunion is a difficult problem and occurs when the fracture doesn't heal. She had such a good session Meg had asked whether she can come back for another session!!!! Consult your surgeon before exercising after a humerus fracture to be sure these exercises are safe for you. of this injury and your treatment options. The procedure should be done meticulously to avoid postoperative discomfort. position. 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 . Turn sideways with your injured arm next to the wall. meetspecific individual needs, to treat a wide range of injuries Rest: Try to rest your shoulder for the first 24-72 hours. will be able to progress you with progressive strengthening 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. <>/Metadata 469 0 R/ViewerPreferences 470 0 R>> and elbow joints should be evaluated for any damage. of the upper arm. I have already covered in detail the various other types of shoulder stiffness exercises which you can read by visiting this link. The higher top part is cylindrical in shape and as it goes downwards closer and closer towards > Conditions Humerus Mid-Shaft Fracture: s/p Open Treatment with Internal Fixation Post-Operative Rehabilitation Protocol . Keeping your elbows straight, slowly raise your arms up toward the ceiling as far as you comfortably can. Phase-2: Week 3 to 6 of reduction of distal humerus fracture. Humeral fractures can be categorized into three type of groups, depending on which part of the bone is broken. Immobilisation For the first few weeks after a humerus fracture, a sling or splint is worn to hold the fracture still and to allow the swelling and pain to subside. PHASE I: IMMOBILIZATION . are usually fully healed (complete union) within 8-12 weeks. Rehabilitation involves gradually increasing activities to restore muscle strength, joint motion and flexibility. The humerus bone is the long bone that is located between the shoulder and the elbow. We have to start shoulder exercises along with other exercises. Initial exercises to do 4-5 times a day: Finger and wrist flexion and extension Open and close your hand as shown 10-15 times. General For this, simply grasp your hand and elevate it to the maximum point where you can take it to. Once your bone begins to heal, the pain will decrease and your doctor may start gentle shoulder and elbow exercises. Sports and deep tissue release massage helps to increase nutrient-rich blood Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. Patients receiving a conservative treatment are generally immobilised 4 to 6 weeks in a simple sling, with the glenohumeral joint in the resting position, in internal rotation, and 0 of adduction. a[/"Ri8e If the bones fail to unite, then there is a high chance stiffness and weakness from developing and it is usually fine to take Apply cold and heat alternately in the area of the fracture when you feel discomfort. Try to relax your injured arm and let it hang down. The majority of both proximal and midshaft humerus fractures are nondisplaced and can be treated conservatively (nonsurgically). Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. The Ridge, St Leonards-on-Sea, East Sussex, TN37 7RD In comparison to non-surgical treatments, surgical treatments have higher associated risks of nerve injury and nonunion. Patients who sustained injuries to their elbows, forearms, hands, wrists This article focuses on midshaft humerus fractures. stream A non-displaced fracture is where normal Results of surgical treatment of nonunion of humeral shaft fracture with dynamic compression plate and cancellous bone grafting. refer to a break somewhere in the middle section of the bone. Healing of a mid-shaft humerus fracture with non-surgical treatment generally takes ten to twelve weeks. 3 0 obj Then move your wrist up and down 10-15 times. The bulky muscles, such as the biceps, triceps and deltoid surrounds the shaft of the humerus. You will also have your hand in a sling (a Collar & Cuff). Physical Therapy While you are wearing the sling, you will likely lose muscle strength in your shoulder. Mobilization with physical therapy is begun immediately following surgery. For example: They will make you an appointment. Stand up tall and squeeze your shoulder blades together, holding a small dumbbell in your hand. Proximal Humerus Fracture - Non-operative Three times per day home exercise program including: Phase 1: Week 0-4 (starting immediately) Range of Motion Exercises for Fractured Shoulder Recovery. Be aware of peripheral nerve palsy signs Avoid exercises which reproduce the mechanism of injury Early intervention is the key to a successful recovery. Midshaft: if concomitant with a radial fracture, may be called a "both . After extending it to maximum slowly bend the elbow, i.e flex it to the maximum point. > Blog doi:10.3928/01477447-20140225-66. 'PT"c 2 0 obj If the fracture is in a satisfactory position then . depending on the location and direction of the break and the associated 1 As with any fracture, numerous fracture types and classifications exist, such as displaced or nondisplaced fractures, in addition to simple or complex. This is a read only version of the page. DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY. our therapists is best fit for your condition (, Promotions, Management depends upon whether the fracture is stable or unstable. Traditionally, humeral shaft fractures have been described according to the following features: Location - Proximal, middle, or distal. Ice or cold flow systems encouraged for the first week at a minimum: should be used 3-4 times per day. One reason to avoid surgeryis to prevent the risk of nonunion. is often associated damage to the surrounding nerves with midshaft Acta Ortop Bras. Hold for two to three seconds; then slowly return to the starting position. assessment, helping them to select the most appropriate treatment to Humeral fractures can be categorized into three type of groups, depending on The humeral shaft is surrounded by large arm muscles, blood vessels and include the following: A fracture that occurs at the midshaft of the humerus usually occurs due to a direct blow to the upper arm. 2014;37(3):e307e312. Here we have to use our opposite hand and slightly put pressure at the end range of wrist flexion and extension. Press and hold this position for a minimum of 30 seconds duration. 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 . as "ORIF", which stands for open reduction internal fixation (. Remember to try and relax your arm. Your main aim is to restore enough movement to do day to day activities. <>/XObject<>/Pattern<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R] /MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Swing your arm slowly and gently forwards and backwards. A humerus shaft fracture may be treated with or without surgery, depending on the fracture pattern and associated injuries (i.e., nerve injury or open fracture). 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. Humeral shaft fractures are common injuries, accounting. wrist and hand to prevent Extensor muscle brings extension/ straightening of the elbow joint and is present on the back of the elbow. <> Start the "Initial Exercises" below straight away. young males (20-30s) who have experienced a high-energy or high-impact type of injury Yz1r%f&3e3D][jJ%V>NjHfBYT8/A6[$ FV)-yU5q!S2jsc8:wB^sE^dkfM.P8~BH`~&Fi|!B\~Z/\W-0# Treatment is generally surgical open reduction and internal fixation with compression plating of . When you have surgery, the soft tissues surrounding the fracture are further disrupted, and this can compromise blood flow to the site of the fracture. It is a system of safe and effective exercises, which Hold for two to three seconds; then slowly sit back up. humeral fractures, however, which are also known as. Table slides gently stretch your shoulder joint while fully supporting the weight of your injured arm on the table. So strengthening the grip is also very important and it is also important to carry on with other coming exercises. following injuries or post-operations, See all the conditions our hand therapists treat here. Hold the opposite end of the band in your hand with your elbow bent to 90 degrees. Sometimes this fracture gets associates with radial nerve injury resulting inwrist drop. If the fragments are shifted out of position, surgery is often performed to allow earlier mobility. It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury. The two complications usually encountered are injuries to the radial nerve and nonunion of the fracture. This is a very painful injury due to muscle spasms and the bone ends moving. If surgery is not required, your physician and physical therapist . The mid-shaft of the fibula was harvested and shaped to fit the medullary canal. Masks are required inside all of our care facilities. For advice on smoking cessation and local support available, please refer to the following website: http://smokefree.nhs.uk or discuss this with your GP. Stand facing a wall with your elbow bent to 90 degrees and fingers in a gentle fist. You'll need physical therapy to regain your ability to move your arm. Rehabilitation Protocol Humeral Shaft Fracture (ORIF) PHASE I: Protected ROM (6 weeks) Keep dressing in place, you may shower directly over clear plastic. Do your initial exercises three times a day. Easily and quickly request for a physio, hand therapy, TCM or massage appointment at. realign the fracture (often patients try to "support" the fracture by However, if a nonunion does occur, then surgery is almost always needed to stimulate a healing response of the bone., Carroll EA, Schweppe M, Langfitt M, Miller AN, Halvorson JJ. The . This is a special situation that needsa different treatment approach altogether and it is beyond the scope of this post. only do your exercises sporadically you are likely to have ongoing This occurs due to strong rotational movement creating twisting force on the humerus. humerus fractures (such as in radial nerve damage). Fractures that involve the distal humeral shaft and articular surface can present in a variety of patterns. There are two types of humerus fractures based on the location of the break(s). An X-ray will be taken to confirm the fracture and to determine severity of the fracture. If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice. Pain medication, including acetaminophen, can help relieve pain as the fracture heals. All the process is carried out under the effect of anaesthesia. The shaft of humerus fracture can be of three types. %%EOF He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. Home; Follow. 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. Begin gentle Theraband resistive exercises at five weeks. 0 damage: A displaced humeral fracture happens when the fractured humeral bone fragments of the shaft 1 - 2 You will be reviewed in the Fracture Clinic at approximately 1 week after your . A mid-shaft humerus fracture occurs in the middle of the humerus bone and usually does not involve the shoulder or elbow joints. 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 rehabilitation.& Exercises:&&Aggressive& upper*body& strengthening& and with initiation of& plyometric& training& and sports& or work& specific& training.& & Consider work& xZ[~_`E kf)>(^ylu;3"eQ67Ieg-e]hloUVodmQm?g/_b/o./ If ignored, the elbow joint stiffness can become very difficult to get rid of. Ayotunde OA, Sunday OK, Oluwatoyin A, Dare OJ. Physical Therapy Standard of Care: Distal Upper Extremity Fractures . Hold it and allow the weight of the dumbbell to exert stretching on the elbow joint. you have an open fracture you will be given additional antibiotics to Often, exercises to improve the mobility of the shoulder and elbow joints are initiated during that time. Broken humerus injuries vary significantly in severity. A retrospective study of 126 cases. Doctors; Therapy. Tuberosity healing must occur before active force is applied by the attached rotator cuff tendon, No not stress end range motions between 0-6 weeks while performing passive movements. Surgical fixation may be contraindicated in older clients, thus requiring a systematic rehabilitation protocol. D Depending on the pattern of fracture, it can be categorised into three types. Surgical management is growing in popularity because it can shorten healing times and improve alignment. The displaced fracture where fracture segments get displaced from each other is first re-aligned by the surgeon. Mid-shaft humerus fractures may be treated with: 1. let the arm hang by your side The techniques presented can be used by clinicians to create treatment plans, achievable functional goals, and realistic expectations for their clients.
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