ORIF Clavicle / Hook Plate Clavicle

 

On ward:

  • 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.
 

2-6 weeks:

  • 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).
 

6-12 weeks:

  • 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