Phase I: Weeks 0-1
GOALS:
- Control pain and swelling
- Protect the clavicle fracture repair
- Protect wound healing
- Begin early shoulder motion
ACTIVITIES:
Immediately After Surgery
1. After the surgery you will be taken to the recovery room, where your family can join you.
You will have a sling and an ice pack on your operated arm.
2. Activity: Dr. Meininger encourages gentle activity immediately after surgery. Getting out of bed and walking in your sling can help you circulate blood, open your lungs and feel more normal after surgery. Be cautious not to use the operated arm or lift anything as instructed.
3. Difficulty sleeping is a frequent complaint. Dr. Meininger recommends a semi-reclined position to support your scapula (shoulder blade). Resting in a recliner chair or with a stack of pillows beneath your back will often suffice.
4. You will receive several prescriptions after surgery for use at home:
- A narcotic pain pill helps control pain. Use as directed. You may gradually substitute over the counter pain relievers as your pain allows.
- An anti-inflammatory is recommended to reduce pain, swelling, and inflammation.
- A stool softener to help prevent constipation (common while taking pain pills).
- Aspirin tablets for use daily or another blood thinner to reduce the risk of blood clots.
5. Apply cold packs to the operated shoulder to reduce pain and swelling 20 minutes each hour with a T-shirt or cotton washcloth between the ice and your skin.
5. Regular finger, hand, and elbow motion is encouraged to increase circulation.
6. Numbing medicine (ie: Novocaine) in the skin after surgery helps to control pain for 12-18 hours after surgery. Nonetheless, Dr. Meininger encourages you to use pain pills for the first 2-3 days after surgery to help control and prevent severe pain.
7. Blood clots: Blood clots are uncommon after clavicle fracture surgery; but still possible. Dr. Meininger encourages early walking and activity; as well as a blood thinner such as Aspirin.
Days After Surgery
1. Your bandage is waterproof and you are safe to shower over the dressings. After 3 days you may remove the dressings cleanse the wound with soap and water. Do not scrub. Do not apply any topical lotions, ointments or gels to the wound. Re-apply clean, dry bandages as needed.
2. Apply cold packs to the shoulder 20 minutes each hour to reduce pain and swelling.
4. Remove the sling several times a day. Keeping your arm at your side, bend and straighten the elbow, flex the wrist, hand and fingers. Bending over to perform pendulum exercises is recommended 3 to 5 times daily.
5. DO NOT lift your arm at the shoulder using your muscles.
6. Because of the need for your comfort and the protection of the repaired clavicle fracture, a
sling is usually necessary for 3 to 4 weeks, unless otherwise instructed by your surgeon.
Phase II: 0 to 6 weeks after surgery
Goals:
- Protect the surgical repair
- Ensure wound healing
- Prevent shoulder stiffness
- Regain range of motion
- Control pain and swelling
Activities:
1. Sling
Use your sling most of the time for the first 3 weeks. The doctor will give you additional instructions on the use of the sling at your post-operative office visit. Remove the sling 4 or 5 times a day to do pendulum exercises.
2. Use of the operated arm
Do not elevate surgical arm above 90 degrees in any plane for the first 3 weeks post-op. Do not lift any objects over 1 or 2 pounds with the surgical arm for the first 6 weeks. Avoid excessive reaching and external/internal rotation for the first 6 weeks.
3. Showering
You may shower or bath and wash the incision area. To wash under the operated arm, bend over at the waist and let the arm passively come away from the body. It is safe to wash under the arm in this position. This is the same position as the pendulum exercise.
Exercise Program
ICE
Days per Week: 7 as necessary 15- 20 minutes
Times per Day: 4-5
STRETCHING / PASSIVE MOTION
Days per Week: 7 Times per day: 4-5
Program:
- Pendulum exercises
- Supine External Rotation
- Supine assisted arm elevation limit to 90 degrees weeks 1 to 3
- 120 degrees weeks 3 to 6
- Isometric exercises: internal and external rotation at neutral
- Elbow and forearm exercises
- Ball squeeze exercise
- Scapular retraction