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Proximal humerus fracture

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Mrsboots87

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May 31, 2018
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Hey,
On 12/3, my daughter fell from the high bar and buckle fractured her left humerus close to the shoulder. Ortho didn’t set it (as is apparently standard for this fracture in this location) and it has healed with about a 30 to 40 degree angulation. The angulation of the bone can be felt on the front side of her arm near the shoulder. Ortho says the healing looks great and it will straighten out as she grows.
The problem is I’m worried. She has been in PT 2X/week since 4 weeks post fracture and has slowly increased what they do to now doing stretch, massage, resistance, and strengthening. But she can’t get her arm past 160 degrees (Teaching abkve her head) without being stretched. And it hurts a little when she is stretched to 180. I expect the pain due to the injury being less than 3 months old and tightness from being in an imobilizer for 2 weeks followed by a sling for another 2 weeks before being cleared for range of motion and PT. She has only been able to do legs and core conditionOmg and dance and leap practice at gym. She should be cleared for impact and swinging this Thursday when we follow up again. PT has voiced concern in the last 2 weeks that the angulation of the bone healing may be causing a limited range of motion. But also says there’s a chance it’s just still very tight from not using her arm like she normally does. He basically said it could either be that the bone is causing limited range of motion completely, or starting bar swinging and mild impact may help loosen her shoulder up the rest of the way as she basically “relearns” how to move her shoulder post injury. He just expected her to have full range of motion by now. And I trust his concern because he is our gyms recommended PT and works with a lot of gymnasts injuries as well as other sports injuries.

Has anyone had experience like this? I was originally told by ortho that not setting the bone and letting it heal how it heals is the normal practice and usually ends with minimally affected range of motion after PT. But, when even the PT is concerned about it, it makes me wonder if she really is limited or just needs more time. When she goes to straighten her arm up above her head, when she gets “stuck” the lump where the bone is broken is sitting right on top of the scapula/clavicle area, but it also feels swollen. That’s also where she says the pain comes from when stretching. She’s been so good about working through the mild pain because she wants to get back to gym. Would I be out of line to ask for a surgical consult about repairing the arm back to straight from the angulation it’s at now? Or for anyone else with a similar fracture, has time and PT been the answer? I do t want to jump straight to surgery because obviously at this point she’s mostly healed and they would essentially need to re break the bone and pin it back together to get it straight and will had even more time with pain and PT.

Just looking for experience of others with an upper arm/should fracture that wasn’t surgically repaired or set before healing.
Thanks
 

Aussie_coach

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That is not a common injury, you probably won’t get a lot with a direct personal experience. But if you are concerned and unhappy with the treatment your child is receiving. I would seek out a second opinion.

We are not allowed to give any medical advice on here, and coaches especially will be careful not to say anything that sounds even remotely like medical advice, for our own safety.

But we can encourage you to seek it from the right sources. I would trust your instinct, if it doesn’t feel right don’t be afraid to dig deeper.
 

Mrsboots87

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May 31, 2018
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That is not a common injury, you probably won’t get a lot with a direct personal experience. But if you are concerned and unhappy with the treatment your child is receiving. I would seek out a second opinion.

We are not allowed to give any medical advice on here, and coaches especially will be careful not to say anything that sounds even remotely like medical advice, for our own safety.

But we can encourage you to seek it from the right sources. I would trust your instinct, if it doesn’t feel right don’t be afraid to dig deeper.

I thought about writing that I’m not looking for medical advice but ended up not adding it in. More of just wondering if others with limited range of motion in a shoulder fracture were able to regain it over time.

I agree that this is a bit of a long shot since most gym injuries tend to be ankles, elbows, and low back stuff. Not too many upper arm injuries. She had a freak fall feom the bar and landed on her shoulder just right apparently. Ugh. I am leaning toward getting a second opinion from another ortho if her Thursday appt doesn’t yield any answers on her potential future shoulder movement.
Thank you for responding. :)
 

Flyaway

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I don't think that it would hurt to get a second opinion. I'm sorry your dd is going through this.
 

NY Dad

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I don’t have personal experiences with a shoulder injury and my dd’s situation was different, but I agree with getting an opinion from a second Ortho.

When my dd fractured her elbow and continued to have limited range of motion the PT suggested we get a second opinion. Her ortho kept insisting that she would continue to get more range of motion over time. The second Ortho informed us that her elbow hadn’t been set correctly. For her situation he said that other than not being able to come close to touching her shoulder (and getting deductions in competitions) that unless the pain continued (which it didn’t) there was no reason to break and reset it.

After several months she wasn’t in pain, she could hyperextend but she was unable to fully flex her elbow.
 

moogacat

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Nov 1, 2018
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I have had a non-displaced proximal humerus fracture. I don't know how mine compared to your daughter's, but even though I did not need surgery the workers' comp carrier involved (not always the most generous with approvals) had pre-approved surgery before I even saw the ortho due to the nature of the injury. If you are uncomfortable with how things are progressing, I would not hesitate at all to get a second opinion.
 
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