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Weaver-Dunn Rehabilitation Protocol BY TENDAYI MUTSOPOTSI

Weaver-Dunn Rehabilitation Protocol BY TENDAYI MUTSOPOTSI

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The purpose of this protocol is to provide the physiotherapist with a guideline for the post- operative rehabilitation course of a patient that has undergone and acromioclavicular joint stabilization following a dislocation. It is not intended to be a substitute for appropriate clinical decision-making regarding the progression of a patient’s post-operative course. The actual post surgical physiotherapy management must be based on the surgical approach, physical examination/findings, individual progress, and/or the presence of post-operative complications. If a physiotherapist requires assistance in the progression of a post-operative patient they should consult with Mr. Andrew Sankey (Shoulder Consultant) or Mr. Tendayi Mutsopotsi (Specialist Shoulder Therapist)
The purpose of this protocol is to provide the physiotherapist with a guideline for the post- operative rehabilitation course of a patient that has undergone and acromioclavicular joint stabilization following a dislocation. It is not intended to be a substitute for appropriate clinical decision-making regarding the progression of a patient’s post-operative course. The actual post surgical physiotherapy management must be based on the surgical approach, physical examination/findings, individual progress, and/or the presence of post-operative complications. If a physiotherapist requires assistance in the progression of a post-operative patient they should consult with Mr. Andrew Sankey (Shoulder Consultant) or Mr. Tendayi Mutsopotsi (Specialist Shoulder Therapist)

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Published by: Physiotherapy Care Specialists on Nov 07, 2012
Copyright:Attribution Non-commercial

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12/15/2013

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- 
WEAVER-DUNNPROTOCOL
PHYSIOTHERAPYLEDPOSTOPERATIVESHOULDERCLINIC
COMPILEDBY:TENDAYIMUTSOPOTSIBSc.HPT(Hons)MSc.ORTHO-MEDMCSPMSOM
APPROVEDBY:MRANDREWSANKEYORTHOPAEDICCONSULTANTSURGEON
 
- 
Weaver-DunnPost-OperativeRehabilitationProtocol
The purpose of this protocol is to provide the physiotherapist with a guideline for the post-operative rehabilitation course of a patient that has undergone and acromioclavicular jointstabilization following a dislocation. It is not intended to be a substitute for appropriate clinicaldecision-making regarding the progression of a patient’s post-operative course. The actual postsurgical physiotherapy management must be based on the surgical approach, physicalexamination/findings, individual progress, and/or the presence of post-operative complications. If a physiotherapist requires assistance in the progression of a post-operative patient they shouldconsult with Mr. Andrew Sankey (Shoulder Consultant) or Mr. Tendayi Mutsopotsi (SpecialistShoulder Therapist)
Procedure
Usually done as an open procedure where the dislocation is reduced. The coraco-acromial ligament isdetached from the acromion and grafted into lateral end of the clavicle. The graft is protected in theearly stages sutures passing over the clavicle attached to anchors in the coracoid. The patient mayexperience a small pop when the sutures give in at about 6 weeks. Please Note: graft is vulnerable tostretching between 6 and 12 weeks and will regain its maximum strength around 36 weeks postprocedure.
Goals
 
Regain FROM
 
Achieve good static and dynamic scapula control
Precautions
 
Avoidcaudalandaxialloading
 
Slingmaintainedforabout6weeks
Day1
 
Noactiveorpassiveshouldermobilization
 
Homecryotherapyadvice
 
Commencescapulasettingandposturalinput(formsmainstayofrehabilitation)
 
Advisereuseofslingandpendularpositioningforwashingunderarmonly,notasanexercise
 
Foldarms,restonpillow/armchairwhileinslingifpositioningthearminordertounloadtheACJandshouldergirdle
 
Emphasisereprotectionofthegrafti.e.avoidingloadingfor12weeks
 
Commencerecervical,elbow,wristandhandexercises
 
 
- 
Week 1
Continue protection in immobilizer or sling
Patient out of immobilization for elbow, wrist and hand exercises
Putty exercises
May begin gentle Codman
s exercises
May begin bicep/triceps isometrics
May begin PROM to pt. tolerance
Week2
 
Checkwoundandremovesutures
 
Continue sling
Continue Codman
s exercises
Continue PROM
May add light weight to hand and wrist
May do weighted elbow exercises if supported
May begin AAROM
Week3
 
ContinueAAROMandPROMincomfortrange
 
MaybeginAROM
 
Startlowlevelisometriccuff
Week4-6
 
Maydiscontinueslingandemphasizeimportanceofposture
 
AAFlexioninsupineto90
°
 
AAExternalrotationinsupine
 
Progressscapulaexercises
Precautions
 
AvoidHBBandaxialloadinge.g.carryingshopping
Week8
 
ProgresstoFAROMinsupineand90
°
instanding
 
StartphaseI&IIhandsbehindback
 
Starthandsbehindhead
 
Progressscapulacontrolandstrengthening
 
Continuebeingcautiousaboutaxialloadingtoprotectrepair

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