(Protocols are similar to TER, as stability and bone healing are priorities.)
| Time | Day 0 | 0–2 weeks | 2–4 weeks | 4–6 weeks | 6–12 weeks | 12+ weeks |
| Immobilisation & Protection | Long-arm posterior slab/cast or brace post-op (usually ~2 weeks). | Splint removed; begin gentle elbow motion. Continue sling as needed. | Full ROM allowed; protect fracture fixation sites. | Discontinue sling; keep elbow moving. | Progress to full AROM; focus on flexion and supination. | Resume normal activities with precautions. |
| Mobilisation/Exercises | Hand/wrist/shoulder mobility; no elbow movement if in cast. | Active-assisted then active elbow flexion/extension and forearm rotation (pain-tolerant). Gradual increase. | Continue progressive elbow ROM; scapular and shoulder exercises. | Initiate gentle strengthening (gravity-assisted elbow curls) if fracture stable. | Strengthening with light resistance; work on full extension/supination strength. | Strengthen as tolerated; function-focused rehab. |
| Activity | No weight-bearing; immobilised. | Gentle use of hand; avoid lifting. | Light ADLs (eating, dressing). No heavy lifting. | Begin light functional use (10–15 min chores). | Increased ADLs; careful driving (avoid push-up). | Return to normal life; avoid heavy loading. |
Key clinical points: Hemiarthroplasty around the elbow is usually done for complex distal humerus fractures. Protection of bone and implant is crucial. Like TER, no weight-bearing or lifting on the arm for at least 6–8 weeks[10]. Once the initial immobilisation is off, focus on regaining elbow motion first, then strength. The fracture site and joint need to heal, so strength training is delayed (often not before 8–12 weeks). Weight lifting limits similar to TER (usually ≤5 kg) are typically imposed long-term.
Movement restrictions: Similar to TER – avoid pushing up or lifting >2–5 kg for 3–6 months. No forced motion or aggressive stretching.
Return to function: Sedentary work by ~4–6 weeks. Manual/light activities by ~3–4 months. Full high-demand or contact activities usually not permitted.
