Humeral Shaft Fracture ORIF: Your Journey from Preparation to Full Recovery
In the week leading up to your humeral shaft fracture ORIF, your surgeon will order a pre‑operative physical exam and may request medical clearance. Stop anti‑inflammatory medications such as ibuprofen, aspirin and naproxen and discontinuing herbal supplements about seven days before surgery. Begin cleansing the operative arm and shoulder with antibacterial or surgical soap as directed and prepare your home for recovery by setting up a comfortable resting area, obtaining ice packs and arranging transportation for the day of surgery.
The night before surgery, follow fasting instructions carefully—do not eat or drink anything after midnight unless otherwise instructed. Use half of the prescribed surgical soap to scrub the shoulder and arm, paying attention to the armpit and chest area, then rinse thoroughly. Take any prescribed stool softeners or medications as directed and lay out loose‑fitting clothes for the morning. Try to get a good night’s sleep.
On the morning of surgery, use the remaining surgical soap to clean the shoulder and arm. Do not consume any food or drink after midnight—take only medications approved by your physician. Bring your sling and wear a button‑up or loose‑fitting shirt for ease of dressing. Arrive at the surgical center at your scheduled time; the team will review your medical history, mark the surgical site and administer anesthesia.
After surgery you’ll rest in the recovery area while the anesthesia wears off. A sling with an abductor pillow will stabilise your arm and should be worn continuously for approximately 4–6 weeks. Ice therapy (20–30 minutes three times per day) helps control swelling and discomfort. Pain medications—both prescription and NSAIDs—may be used; avoid driving or alcohol while taking narcotics. Keep the initial dressing clean and dry; you may shower after three days with a waterproof bandage and remove the dressing then, but avoid soaking the shoulder in baths or pools until your doctor allows (usually 2–3 weeks). Driving is not permitted while the sling is required.
During the initial healing phase there should be no weight bearing through the operative arm. The sling and abductor pillow are worn full time for approximately 4–6 weeks, and you may remove the sling only for exercises. The Arm Docs rehabilitation guidelines state that after 4 weeks the sling may be discontinued and active movement through a greater range can begin; strengthening exercises start at 12 weeks. Vigorous use of the arm or lifting heavy objects should be avoided for at least three months. Do not put weight through the arm (such as leaning on a table) during early range‑of‑motion exercises.
Continue to wear the sling full time for comfort and protection. Remove it only for gentle exercises: flex and extend your elbow and wrist and perform shoulder shrugs several times per day. Do not actively lift your arm away from the body, and avoid shoulder flexion, abduction or rotation until your surgeon or therapist allows. Keep the wound dry and use a waterproof bandage when showering; do not soak the incision. Arrange assistance for bathing and dressing since your arm must stay supported. Physical therapy typically begins about two weeks after surgery.
Your first postoperative appointment is usually two weeks after surgery. Dr. Cancienne’s discharge protocol recommends returning to the office at this time to assess incision healing and to receive clearance for physical therapy. Follow‑up appointments will continue at regular intervals with x‑rays to monitor fracture healing for at least 6–12 months.
After about four weeks you may stop wearing the sling and gradually increase active shoulder motion. Physical therapy focuses on restoring range of motion while protecting the fracture site; strengthening usually begins around 12 weeks post‑op. As healing progresses, light activities such as desk work or gentle household tasks can be resumed, but avoid lifting heavy objects or performing overhead motions until your surgeon confirms sufficient healing. Return to driving typically occurs at 3–4 weeks when you are comfortable without the sling.
Bony healing of the humeral shaft generally occurs within 6–8 weeks; however, regaining normal function and motion may require 4–6 months. Vigorous use of the arm or heavy lifting should be avoided for at least three months, and outpatient physiotherapy may continue for 6–12 months depending on your progress. Athletic activities (throwing, lifting, swimming, running and contact sports) should be avoided until you have full strength and are cleared by your surgeon.