The Effectiveness of Physiotherapy After Operative Treatment of Supracondylar Humeral Fractures in Children
Peter Keppler, MD,* Khaled Salem, MSc,† Birte Schwarting, MD,* andLothar Kinzl, MD*
Abstract: The indications for physiotherapy after supracondylar
humeral fractures in children are not clear in the literature, even in the presence of an active or passivelimitation of elbow joint motion. The authors therefore performed a prospective randomized study to assess the effectiveness of physiotherapy in improving the elbow range of motion after such fractures. Theauthors studied two groups of 21 and 22 children with supracondylar humeral fractures Felsenreich types II and III, all without associated neurovascular deﬁcits. All children were treated by openreduction and internal ﬁxation with Kirschner wires inserted from the radial side of the humerus. Postoperative follow-up at 12 and 18 weeks showed a signiﬁcantly better elbow range of motion in the groupwith weekly physiotherapy, but there was no difference in elbow motion after 1 year. In each group, one child had an extension deﬁcit of 15 or 20 degrees. The authors conclude that postoperativephysiotherapy is unnecessary in children with supracondylar humeral fractures without associated neurovascular injuries. Key Words: physiotherapy, supracondylar humeral fractures, range of motion, elbowstiffness (J Pediatr Orthop 2005;25:314–316)
third of all centers prescribe PT after supracondylar humeral fractures (personal communications). The advances in health care in the direction ofevidencebased medicine have inﬂuenced not only doctors but also physiotherapists, with evidence for the effectiveness of PT shifting more to the foreground. We conducted this study to assess whether PT isappropriate in improving the postoperative elbow range of motion (ROM) after supracondylar humeral fractures in children as it does in adults.
PATIENTS AND METHODS
In a prospective randomized study...