Distal Humerus ORIF Fracture Early Motion Therapy Protocol
[Pages:1]Distal Humerus Fracture Open Reduction and Internal Fixation Therapy Instructions - Early Motion Protocol Laith Al-Shihabi, MD
1 week Splint:
-Fashion removable long-arm splint holding the elbow in 90 degrees of flexion and wrist in neutral at 1 week post-op. -Splint to be worn full time except for when performing therapy exercises for the first 6 weeks.
Motion: -Hand/finger AROM/AAROM/PROM encouraged immediately. -Begin active elbow extension/flexion and pro/supination, as well as active and passive wrist flexion/extension.
Edema Control: Per therapist.
2-6 weeks Incision care:
-Begin scar desensitization/massage at 2-3 weeks as wound allows.
Splint: -Continue splint except when in therapy.
Motion: -Continue active elbow extension/flexion and pro/supination, as well as active and passive wrist flexion/ extension. -Begin gentle PROM and continue AROM/AAROM to elbow extension and flexion starting at 4 weeks.
Edema Control: Per therapist.
6 -10 weeks Splint:
-Wean from the splint at 6 weeks, discontinue by 8 weeks. -Static progressive splinting can be initiated if there is failure to achieve at least a 100 degree arc of flexion/ extension by 8 weeks.
Motion: -Advance PROM to elbow flexion/extension and pro/supination, and continue AROM/AAROM exercises.
Strengthening: -Begin forearm strengthening at 6 weeks, and gentle elbow strengthening at 8 weeks. -5 lbs lifting restriction starting at 6 weeks. -15 lbs lifting restriction at 8 weeks. -Transition to a home exercise program by 8-10 weeks.
10-12+ weeks Gradually return to light activity and exercise. There are no further activity restriction after 12 weeks. No further therapy is necessary unless required on a case-by-case basis.
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