When is it most appropriate to begin orthotic management for a mid-shaft humeral fracture?

Initiating orthotic management for a mid-shaft humeral fracture is typically most effective around 7 days post-injury. At this stage, the initial acute inflammatory phase has usually subsided, allowing for better assessment of the fracture's stability and alignment. During the first week after injury, there is often significant swelling and pain, which can complicate the fitting and wearing of an orthotic device.

By waiting approximately a week, clinicians can evaluate the need for orthotic support based on the healing process, as initial assessments may indicate the potential for non-operative management. The orthotic device can help provide support, maintain alignment, and promote healing during the subsequent stages of recovery without overwhelming the healing tissues.

In contrast, initiating orthotic management immediately or shortly after the injury may not be beneficial due to the circumstances mentioned – excessive swelling, potential movement around the fracture site, and difficulties in determining the most effective type and fit of the orthotic device. Waiting too long, like 2 weeks post-injury, may delay beneficial support and slow the rehabilitation process. Therefore, managing orthotics around 7 days post-injury strikes the right balance for effective recovery.