The recovery of elbow range of motion after treatment of supracondylar and lateral condylar fractures of the distal humerus in children.
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.
Wang
Yu-Ling
YL
Departments of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Chang
Wei-Ning
WN
Hsu
Chien-Jen
CJ
Sun
Shu-Fen
SF
Wang
Jue-Long
JL
Wong
Chi-Yin
CY
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