ORIF Clavicle / Hook Plate Clavicle
- Sling for up to 4-6/52 for pain relief. Can be removed for washing, dressing and exercise.
- Day 1 on ward. Active assisted elevation 0-60° in forward lean standing (assisted pendular elevation).
- Teach elbow, wrist, hand and scapular setting exercises.
- Care NOT to hitch scapula.
- Teach sling care and washing
- Active External Rotation as pain allows.
N.B. AVOID axial loading for 3/12. NO long lever strengthening for 10/52.
- Shoulder clinic review 6/52 (with X-ray on arrival) to discuss progression then 4-6/12 review with XR
- NB Hook plates are removed after 4-6/12.
- Aim for controlled quality early motion to 90° by 4/52, pain limiting.
- N.B. CARE not to impinge rotator cuff.
- May progress beyond 90° after 4/52 if pain allows.
- Early Rotator Cuff rehabilitation after 2/52 – GHJ in neutral i.e. medial and lateral rotation – light resistance (30% MVC).
- Progress after 6/52 to regain full ROM as pain and muscle control allows.
- Clinic review with Mr Cole / Mr Hand at approx 6/52.
- No long lever strengthening for 10/52. Progress controlled rotator cuff and deltoid strengthening 6-12/52.
- Ensure scapular dynamic control through full range of movement.
Return to work: Sedentary 4 weeks (as pain allows). Physical 3 months (as guided by surgeon).
Driving: 4-6 weeks (as pain and range allows) patient confirms safety to drive.
Sport: Non contact 3 months. Contact 6-9 months (as guided by surgeon). No contact sports for Hook plate patients until plate removed.
Swimming: Gentle with modified stroke 6-8 weeks. Freestyle 12-16 weeks
Click on the links below to read the guidelines for individual procedures:
- Arthroscopic Sub-Acromial Decompression
- Rotator Cuff Repair
- Arthroscopic Subacromial Decompression + Arthroscopic Excision of Distal Clavicle (ACJt resection)
- Anterior Stabilisation (open or arthroscopic)
- SLAP repair – arthroscopic
- Acromio Clavicular Joint Reconstruction
- Anatomical Shoulder arthroplasty – Hemi arthroplasty (HA) or Total Shoulder Replacement (TSR)
- Arthroscopic Capsular Release and MUA of Frozen Shoulder
- ORIF proximal humeral fractures – (Proximal Humeral Locking Plate)
- ORTHO SPACE (In space Implantation)
- Physiotherapy Protocol for REVERSE Total Shoulder Replacement