How long does the acute immobilization phase last for non-operative proximal humerus fractures?

✓ Accepted answer

The acute immobilization phase for non-operative proximal humerus fractures typically lasts between two and three weeks.

• Initial Duration: Most standard protocols recommend keeping the arm in a sling for the first 10 to 21 days to control pain and protect the healing bone. The specific timeline often depends on the severity of the fracture, with less displaced fractures potentially clearing for motion earlier.
• Gradual Progression: After the initial two weeks, the phase shifts from strict immobilization to active-assisted range of motion. Patients are usually introduced to pendulum exercises, as noted by expert resources, which allow the shoulder to move with gravity to prevent stiffness without placing strain on the healing site.
• Physical Therapy Support: Rehabilitation should begin shortly after the acute pain subsides. In the United States and the United Kingdom, a primary care physician or orthopedic specialist will typically refer you to a physical therapist. They customize the program, ensuring you do not overexert the shoulder before the bone has achieved initial stability.
• Pain Management: During this immobilization period, ice therapy and over-the-counter pain relief are common strategies. Managing discomfort effectively is crucial because uncontrolled pain can restrict movement, potentially leading to the "frozen shoulder" condition later in recovery.
• Monitoring Healing: Regular follow-up appointments are scheduled during these initial weeks to check bone alignment via imaging. This ensures that the conservative treatment is working and that there is no unexpected displacement that might require surgical intervention.

Warning Sign: If you experience sudden, severe pain, significant swelling, or noticeable deformity of the shoulder after the initial healing period, contact a doctor immediately. These symptoms may indicate a new injury or displacement of the fracture, requiring urgent medical assessment.

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