These instructions apply to surgical repair of clavicle (collarbone) fractures, proximal humerus fractures (top of the arm bone, near the shoulder), and humeral shaft fractures (middle of the arm bone). Where instructions differ between fractures, each is listed separately.
Medications
Take all medications exactly as prescribed and follow the instructions on your pharmacy labels.
- Narcotic pain medication (such as oxycodone): take as prescribed, as needed for pain. Try to taper your use as soon as you feel comfortable. You may take Extra Strength Tylenol in place of the narcotic. Do not take additional Tylenol if you are taking Percocet, hydrocodone, or Vicodin, which already contain it.
- Pregabalin: take as prescribed. This is for nerve pain.
- Tylenol (acetaminophen): take as prescribed. You can take it along with your narcotic or in between doses to help manage pain.
- Aspirin: take as prescribed to help prevent blood clots. Continue aspirin for 2 weeks after surgery.
- Anti-inflammatory medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve) are not prescribed after fracture surgery. Avoid ibuprofen and naproxen while you are taking aspirin; use Tylenol instead. After you finish your aspirin, you may take them over the counter if needed, following the package directions.
Diet
Resume a regular diet as soon as possible. It is advisable to start with clear liquids until any nausea is gone.
Sling
Wear the sling at all times for the period listed below. Do not remove it except to shower, get dressed, or do exercises as instructed. Sleep in the sling.
- Clavicle fracture: 4 weeks
- Proximal humerus fracture: 4 weeks
- Humeral shaft fracture: 2 weeks
Frequently Asked Questions
Is bruising and discoloration normal?
Yes. Bruising after fracture surgery can be significant and may spread down the arm or onto the chest over the first week or two. This is normal and not a cause for alarm.
When do I start physical therapy?
Physical therapy starts within 2 weeks after surgery.
What exercises can I do right after surgery?
You can do gentle elbow, wrist, and hand motion starting the day after surgery, and you can start pendulum swings on post-op day 3 (instructions below). Do not actively lift your operative arm away from your body or reach behind your back until cleared by your surgeon.
Can I lift anything with my operative arm?
Do not lift anything heavier than a cup of coffee with your operative arm until your surgeon or therapist clears you.
How do I care for my dressing?
About 1 week after surgery, change your dressing and replace it with a clean bandage over the incision. Your dressing will be removed for good at your first post-op visit. When showering, let water run over the incision without scrubbing, then pat dry. Do not remove the skin glue (Dermabond) or any white strips over the incision.
When should I ice?
Ice is very important after surgery. Use it continuously over the dressing for the first 3 days. After that, ice 3 times a day, especially before bedtime, using a cold therapy unit, an ice pack, or a bag of frozen vegetables.
When is my first post-op appointment?
Your first post-op appointment is typically scheduled before your surgery. If you are unsure of the date, time, or location, contact our office.
When can I start driving?
Do not drive while wearing your sling. Once you are out of the sling and no longer taking narcotic pain medication, you may drive when you feel safe to do so.
When should I call the office?
Contact our office if you notice excessive drainage or blood on the dressing after 5 days, a fever over 101.5°F, or numbness or tingling in your arm or hand that was not present before surgery.
Humeral shaft fractures: contact our office right away if you notice new weakness or difficulty lifting your wrist or straightening your fingers. This can be a sign of irritation of the nerve that runs along the arm bone.
Pendulum Exercise
- Stand and lean forward with your non-operative arm resting on a chair or table. Let the operative arm hang relaxed at your side.
- Gently rock your body forward and back, letting your arm move freely.
- Keep the shoulder relaxed. Do not actively move the shoulder.
- Move forward and back for 45–60 seconds, then side to side for 45–60 seconds, then 30 seconds clockwise and 30 seconds counterclockwise.
Questions or concerns? Call our office at (775) 348-8800. After hours, this line connects you with the on-call physician. For emergencies, call 911.