Week 5

Patient z presented with a fractured left head and neck of humerus 15/10/08. The fracture was to be managed conservatively in a sling for 6 weeks. For the first two weeks i introduced pendulum excercises and gentle passive ROM. I did not begin AROM as the patient is very frail and was experiencing alot of pain. During the 3rd week patient z started to have swallowing difficulties. She was transferred to the emergency hospital and underwent oesophagitis secondary biphosphonate therapy after not eating or drinking for two days. Patient z has returned to the facility for the remaining rehabillitatory period. She is now eating and drinking, however is very weak and has had quite a major set back in her fracture rehab. During my treatment session today, patiuent z complained of neck pain. I had a look at the sling that she has been wearing and it occured to me that all tghe weight of her L UL has been resting on her neck and pulling her into a kyphotic cervical neck position. i decided to go straingth to the OT and organised for another sling to be made with two loops supporting the elbow and the wrist, so that the weight would be evenly distributed across her back. I then began some active assisted ROM excercises. Usuallly by week 4, a patient who is conservatively managed should be introduced to isometric astrengthening exercises. As i do not feel my patient is ready for this progression i will monitor her AROM and progress her when she is ready.