A broken humerus, the long bone of the upper arm, is a common fracture that complicates daily activities, particularly getting dressed. Since the arm is immobilized in a sling or cast for several weeks, manipulating clothing is severely limited. Learning modified dressing techniques is necessary to protect the healing bone, prevent displacement, and minimize pain during recovery. This guidance provides specific strategies to manage this daily routine.
Preparation and Clothing Selection
Successful dressing starts with careful clothing selection. Opting for garments that minimize shoulder and elbow range of motion is beneficial. Loose-fitting tops with full-length front openings, such as button-down shirts, blouses, or zippered hoodies, are recommended because they eliminate the need to pull fabric over the head.
For comfort and ease of movement, consider sizing up by one or two sizes for upper body wear to accommodate swelling or the bulk of a cast. Adaptive apparel, which features hook-and-loop fasteners (Velcro) or magnetic snaps, can be a valuable temporary investment. Before beginning, sit in a sturdy chair with armrests in a clear, well-lit space to ensure stability and reduce the risk of falling or jarring the injured arm.
Techniques for Dressing the Upper Body
The foundational principle for safely dressing the upper body is “Injured In, Uninjured Out”: the affected arm goes into the sleeve first and comes out last. Gather your chosen top and place it on your lap or a nearby surface with the neck opening facing away. Carefully thread the sleeve intended for the injured arm onto the cast or sling, using the uninjured hand to gently guide the fabric over the forearm and up to the shoulder without lifting the injured limb.
Once the injured arm is completely in its sleeve, use the uninjured hand to grasp the collar or neck opening and pull the garment around your back and over your head. This movement should be accomplished by leading with the sound arm, allowing the shirt body to drape over the torso. Finally, insert the uninjured arm into the remaining sleeve and adjust the clothing as necessary, using only the functional hand.
When undressing, reverse the process: remove the sound arm first, slide the shirt off the uninjured shoulder and over the head, and then gently ease the garment off the injured arm to prevent sudden tugging on the fracture site.
For tops that do not open fully, like T-shirts or sweatshirts, lay the shirt flat and bunch the fabric of the injured arm’s sleeve. Gently push the injured hand through the sleeve opening, guiding the fabric up to the shoulder. Then, use the uninjured hand to pull the garment over the head and position it around the neck. This technique requires significant control from the uninjured side and minimal use of the shoulder on the fractured side, which helps maintain the stability of the fracture during the initial healing phase.
Managing Lower Body Dressing
Dressing the lower body requires stability and the use of adaptive tools to compensate for the limited reach of the injured arm. Always remain seated on a stable surface, such as the edge of a bed or a solid chair, while putting on or taking off pants, socks, and shoes. Choose trousers with an elastic waistband or a wide, loose fit. These are easier to manipulate with one hand and eliminate the need for fine motor skills like buttoning and zipping.
To put on pants, place both feet into the leg openings, using the uninjured hand to pull the waistband up to the knees. If you have difficulty reaching, a dressing stick can be used by hooking the waistband or a belt loop to pull the garment up over the thighs. Once the pants are at the knees, stand up using a stable surface for support. Then, “hitch” the pants up by shifting weight from side to side and using the uninjured hand to pull the waistband the rest of the way.
For socks, a specialized sock aid is highly effective. It allows you to load the sock onto a plastic gutter device and then use long straps to pull the sock over your foot without bending over. Alternatively, you can cross the ankle of the leg you are dressing over the knee of the uninjured leg, bringing the foot closer to the working hand. Footwear should be simple, favoring slip-on shoes, loafers, or those with hook-and-loop closures to avoid the task of tying laces with one hand.
Safety Considerations and When to Seek Help
During dressing, your primary goal is to protect the healing humerus from undue stress or sudden movements. It is advisable to time your routine to coincide with the peak effectiveness of prescribed pain medication, typically 30 to 60 minutes after taking it. Never force the injured limb into a position or sleeve, and immediately stop any movement that causes a sharp increase in pain.
Avoid any action that involves lifting the injured arm away from the body, as this uses the surrounding musculature and could destabilize the fracture.
Warning Signs Requiring Medical Attention
Be vigilant for warning signs that may indicate a complication requiring immediate medical attention. These signs include:
- New or worsening numbness or tingling in the fingers.
- A sudden increase in swelling below the cast or sling.
- Severe, sharp pain that persists despite rest and pain medication.
- Any change in the color or temperature of the hand or fingers.
Promptly contact your physician if any of these occur to ensure that the blood supply and nerve function are not being compromised.