For a printable version of these instructions: click here. Dr. Solberg’s Office Number is 213-455-8448 This information should be useful after your fracture repair surgery. Please read this information carefully. You will receive further instructions at your next visit. The following items cover what to expect and what to do for the first week to 10 days after surgery.
Expect your shoulder to be quite stiff and sore for the first few days. Keep your arm in the sling most of the time. You may take the sling off to wash. Take your arm out of the sling a couple of times a day and bend and straighten your elbow. This will help improve your motion. Squeeze and relax your fist often to improve circulation.
Apply ice to your shoulder for the first 48 hours after surgery. Wrap the ice in two bags to avoid getting the bandage wet. You may use ice packs longer if they help the pain. You should expect some swelling in your hand and fingers on the affected side as well as some bruising in the arm and chest area, this is perfectly normal. This will subside when you begin to move your arm more.
PAIN MEDICATION
Many patients have a block or regional anesthetic for pain control after surgery. This produces numbness in the involved arm and is very good at relieving pain after surgery. The block often lasts 12-24 hours before it wears off, which can occur fairly quickly. The first sign the block is wearing off is tingling in your fingers, the same type of feeling you have when you lay on your hand and it “falls asleep”. It is very important to have pain medication in your system when the block is wearing off to avoid having excessive pain. I recommend you take an extra dose of the pain medication as soon as you feel tingling in your hand.
Take your pain medication as directed by your prescription. Do not wait until the pain is intolerable to take the medication. It will take between 30-60 minutes to begin working, so take it accordingly. In addition to your prescription, recommend combining it with either Advil or Aleve for an additive or synergistic effect (the effect of the two medications together is more than the effect of the individual medications). Over the counter Advil or Aleve work as well as prescription ibuprofen or naproxen (the generic form) and can be safely taken with your prescription. For Ibuprofen (Advil or Motrin) take 3 tablets (600 mg) every 8 hours as needed and for Naproxen (Aleve) take two tablets (440 mg) every 12 hours. Do not take both ibuprofen and naproxen, rather choose one or the other. Make sure you take these medications with food to avoid stomach upset.
WOUND CARE
Take the bandage off after 3 days. The incisions may continue to ooze a small amount. If you have tape strips on the wounds leave them alone and don’t pull at the edges. They will loosen up spontaneously and come off over the next 1-2 weeks. You may shower after the third day and wash the incision with soap and water and dry gently with a towel after showering. Do not soak your arm or shoulder underwater and don’t swim in a pool for at least 2 weeks after surgery. If you still have some drainage from the incision, put a dry gauze pad on the incision, if there is no drainage; leave the incision open to air. You should begin to gently move your shoulder as soon as you can. Your motion should improve a little bit every day. Start by removing your arm from the sling and leaning over a table, allowing your arm to hang free. Gently begin drawing circles with your arm, first in one direction then the other. These are called Codman exercises ( see the below diagrams). Each day try to increase the size of these circles. Do these exercises 2-3 times a day.
Codman Exercises
If you’re having trouble falling asleep you can take a gentle over the counter sedative such as Benadryl or Unisom. These can be taken safely with your pain medication and help you to fall asleep more quickly. Don’t drink alcohol with the pain medication or sleep aid as this can be dangerous. The other exercise that is useful is to gently bend and straighten your elbow several times a day. You can do this in conjunction with the gentle shoulder exercises. Do not lift anything heavier that a coffee cup. You can use your arm for writing, working on the computer and fine motor tasks such as manipulating small objects but do not attempt to lift anything heavier than about a pound. This can create stress on the surgical repair and can lead to injury.
Many people have difficulty sleeping for the first week after surgery. If you have a preferred position for sleeping (e.g. on your side) you probably won’t be able to get into this position comfortably. Lying flat on your back often uncomfortable as well. The most comfortable position that patients report to me is sitting up about half way with lots of pillow around their torso to keep them from rolling over or tilting. You can put yourself in any position except laying directly on the involved arm/shoulder and it you may have to experiment a little to find a comfortable position. Many people tell me sleeping in a recliner is the best way to get through the first week. Make sure you have some way of staying in this position while you sleep. If you have trouble falling asleep you can take an over the counter medication such as Unisom or Benadryl to help you fall asleep and you can take these safely with your pain medication. I prefer Unisom because it works a little faster than Benadryl.
Some people will have a pillow between their arm and chest after surgery to hold their arm away from their body. It is important to have someone help hold your arm in this position when removing the sling and pillow such as when you take a shower.
Call Dr. Solberg’s Office if you notice any of the following symptoms.
with an associate if you are calling in the evening hours. Have your discharge orders and description of your procedure available.
- Temperature over 101° Fahrenheit
- Persistent numbness in your hand
- Increasing, severe pain in the shoulder
- Increasing redness around the incisions
You have been prescribed pain medication which has a number of side effects. Most common are drowsiness, nausea and or vomiting, itching, constipation and irritability. If these are prolonged or severe, your pain medication may need to be changed. You must contact our office during business hours to have a prescription refilled or a new prescription dispensed. After hours (after 5:00 pm or weekends), the on call doctor will not give you a refill or a new pain medication prescription.