title: The recovery of elbow range of motion after treatment of supracondylar and lateral condylar fractures of the distal humerus in children.
abstract: OBJECTIVE
  To investigate the time required for elbow range of motion (ROM) recovery after supracondylar and lateral condylar fractures in children and to analyze the relationship between the ROM recovery and the related factors.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary pediatric orthopaedic care unit at a general hospital.
  
  
  METHODS
  Forty-five children with distal humerus supracondylar fractures and 16 children with lateral condylar fractures were followed. Twenty-seven children with distal forearm fractures, which were immobilized with long arm casts, were used as a control group to study elbow flexion-extension recovery after immobilization without elbow fracture.
  
  
  METHODS
  Elbow ROM was measured with a goniometer in a series of follow-up visits after cast removal until 90% ROM of the uninjured side had been reached. Morrey's definition was used to define ROM required for functional activity of daily living.
  
  
  RESULTS
  The supracondylar fracture group took 29.5, 39.0, 6.1, and 11.0 days to achieve 90% ROM in extension, flexion, supination, and pronation directions. The lateral condylar fracture group needed 30.2, 35.6, 2.3, and 8.9 days, respectively, in 4 directions. In the distal forearm fracture group, the elbow total flexion-extension angle required less than 2 weeks to reach a total arc of 135 degrees. The supination range was easier to recover than the pronation motion. The flexion recovered last among 4 directions in supra- and lateral condylar fractures.
  
  
  CONCLUSIONS
  In the uncomplicated distal humerus supracondylar and lateral condylar fractures, it takes 5 weeks to restore original elbow ROM after removal of long arm cast without physical therapy. This information could be applied in the education material to caregivers of children with elbow injuries.
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Wang
authors.forename: Wei-Ning
authors.initials: WN
authors.lastname: Chang
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Hsu
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Sun
authors.forename: Jue-Long
authors.initials: JL
authors.lastname: Wang
authors.forename: Chi-Yin
authors.initials: CY
authors.lastname: Wong
mesh_terms: D000203:Activities of Daily Living; D002370:Casts, Surgical; D002648:Child; D004551:Elbow Joint / Q000503:physiopathology*; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000628:therapy*; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies