Recovery Time for Humerus Fracture with Surgical Repair
For a relatively healthy adult or adolescent undergoing surgical repair of a humerus fracture, expect acute symptoms to subside over 6-8 weeks as the fracture heals, with full functional recovery typically achieved by 3-6 months. 1
Fracture Healing Timeline
The primary healing phase occurs within 6-8 weeks, during which acute symptoms progressively resolve as the fracture consolidates. 1 This represents the period when bony union is actively occurring and immobilization or activity restrictions are most critical.
Functional Recovery Expectations
For Proximal Humerus Fractures
- Most patients achieve functional recovery within 3-6 months following surgical fixation. 1
- The initial 6-8 weeks focus on fracture healing, followed by progressive rehabilitation to restore range of motion and strength. 1
For Adolescent Intra-articular Distal Humerus Fractures
- Adolescents can expect no significant loss of motion or strength compared to the uninjured limb after surgical intervention. 2
- Mean follow-up data at 1.22 years showed active range of motion averaging 123.4 degrees (10.7 to 133.9 degrees). 2
- Objective testing revealed 6 excellent and 1 good result out of 9 patients using the Mayo Elbow Performance Score. 2
Important Considerations Affecting Recovery
Fracture Pattern Impact
More complex fracture patterns (AO classification type C2 and C3) result in significantly greater motion loss than simpler patterns. 2 This should temper expectations for patients with comminuted or severely displaced fractures.
Radial Nerve Injury Considerations
If radial nerve palsy is present (inability to extend wrist against gravity):
- 90.6% of patients show first signs of nerve recovery within 6 months. 3
- 84.3% achieve full motor function by 12 months, and 94% by 18 months. 3
- Average time to full nerve recovery is 6 months (range 1-21 months). 4
- Even if no recovery is evident at 7 months, there remains a 56% probability of recovery by 18 months. 5
Rehabilitation Approach
Early Phase (0-6 weeks)
- Immobilization is maintained during initial fracture healing. 1
- Avoid prolonged bed rest, as it causes significant loss of lower extremity strength and aerobic capacity equivalent to a decade of age-related decline. 1
Recovery Phase (6 weeks to 6 months)
- Progressive mobilization and strengthening as fracture healing permits. 1
- Note: Current guidelines cannot recommend for or against routine supervised physical therapy due to insufficient evidence, though this remains common clinical practice. 6
Critical Pitfalls to Avoid
Do not delay osteoporosis evaluation in appropriate patients, as there is a 20% risk of another vertebral fracture within 12 months. 1 This is particularly important for low-energy fractures in older adults.
Perioperative complications occur frequently (20 complications in 15 patients in one adolescent series), with nerve palsies being most common. 2 Patients should be counseled about this risk preoperatively.
Patience is essential for nerve recovery—complete recovery can be delayed up to 21 months, and early surgical intervention for nerve palsy is unlikely to be beneficial within the first 7 months. 5, 4