Proximal Humerus Fracture ORIF: Your Journey from Preparation to Full Recovery
In the week leading up to your proximal humerus fracture ORIF, your surgeon will order a pre-operative physical exam and may request medical clearance from any specialists. Patients should stop medications that thin or anticoagulate the blood (like ibuprofen, aspirin, naproxen and other anti-inflammatory medicines) and discontinue herbal supplements about seven days before surgery. Your physician will provide guidance if you take prescription blood thinners like Coumadin or Plavix. Use this time to prepare your home for recovery—set up a space with a reclining chair to support your arm, gather ice packs, and arrange for help with daily tasks. Eat a balanced diet and stay well‑hydrated to promote healing.
The night before surgery, follow the NPO instructions carefully. Patients should not eat or drink anything after midnight—including coffee, milk or chewing gum—unless instructed otherwise. Use half of the soap to scrub the shoulder, chest and armpit the night before surgery and rinse thoroughly. Take any prescribed stool softeners or medications as directed by your surgeon. Place out loose‑fitting clothing for the morning and try to get a good night’s sleep.
On the morning of surgery, use the remaining surgical soap to clean the operative shoulder area as you did the night before and avoid eating or drinking except for medications approved by your physician. Arrive at the hospital at the designated time for your pre‑operative check‑in and anesthesia evaluation. The operating team will review your medical history, mark the surgical site and place an intravenous line. Proximal humerus ORIF is typically performed under general anesthesia with a nerve block for postoperative pain control—an interscalene block can reduce nausea and allow early intake of food and drink【539399275522130†L112-L124】. Bring your sling and any paperwork provided at the pre‑operative appointment.
After surgery you will spend time in the recovery room while the anesthesia wears off. Rest during the first few days, wearing your sling at all times (including sleeping) and keeping a pillow under your forearm for comfort. Use ice or a cryo‑cuff as much as possible for the first 3–4 weeks to reduce swelling. Begin gentle pendulum and elbow/wrist range‑of‑motion exercises the day after surgery. Keep the waterproof dressing intact for about a week; you may shower with the dressing on but avoid submerging the incision until your surgeon allows. Pain medications (such as oxycodone or NSAIDs) will be prescribed; follow the dosing instructions and avoid driving or operating machinery while taking narcotics.
Weight‑bearing restrictions are strict in the early weeks. Dr. Murar’s instructions advise not lifting anything heavier than about 1 pound for the first 4–6 weeks after surgery. The Reno Orthopedic Center protocol adds that patients should not lift more than 5 pounds during the first six weeks, and once x‑rays confirm good healing they can gradually return to regular lifting. Dr. Stirton’s guideline says to wear the sling continuously for two weeks, then while sleeping and when out of the house for another four weeks, and not to lift any weight with the operative arm during this period【77601663033969†L49-L55】.
During the first week after surgery continue wearing the sling continuously. Remain in an abduction sling 24 hours a day for the first two weeks and only removing it for showers and exercises. Sleep in a reclined position with a pillow supporting your arm. You should begin pendulum (Codman’s) exercises and gentle elbow, hand and wrist movements multiple times per day. Keep the dressing dry and waterproof; you may shower but do not immerse the incision and avoid soaking or swimming for at least six weeks. Continue ice therapy for 20–30 minutes every two hours to control pain and swelling【77601663033969†L79-L88】.
You should schedule your first postoperative visit approximately 10–14 days after surgery. The surgeon or physician assistant will assess the incision, remove sutures and review the intra‑operative findings. Further visits usually occur at 6 weeks and 3 months after surgery to monitor bone healing with x‑rays and adjust your therapy plan.
Patients generally begin moderate activities and active range‑of‑motion exercises after the initial immobilization phase. The Reno Orthopedic Center notes that physical therapy starts after the first clinic visit and that patients spend about four weeks focusing on range of motion before beginning strengthening at six weeks. Most patients require 3–4 months of therapy to regain pre‑injury range of motion and strength. The Crystal Lake rehabilitation protocol confirms that bony healing typically occurs by 6–8 weeks and that return to normal function may require 3–4 months. Thus moderate activity—such as light household chores or desk work—usually resumes around three months, but heavy labour should wait until your surgeon confirms adequate healing.
Complete recovery after proximal humerus ORIF can vary based on fracture severity and patient factors. Early bony healing occurs within 6–8 weeks and full return to normal function may take 3–4 months. Returning to jobs requiring moderate lifting or manual labour often takes 12 weeks Heavy lifting and high‑impact activities should be avoided until cleared by your surgeon. Many patients continue therapy for several months and may not achieve maximal strength and motion until 6–12 months post‑surgery. Always follow your surgeon’s recommendations and communicate any concerns during follow‑up visits.