The role of physiotherapy after operative treatment of supracondylar humeral fractures in children remains controversial. Several authors recommend physical therapy while others reject its usefulness. This prospective randomized study attempted to answer the question of the effectiveness of physical therapy. Inclusion criteria included children between the ages of 5 and 12 years with an isolated supracondylar humeral fracture that underwent open reduction and fixation. One group of children consisted of 24 patients that did not undergo physical therapy. The second group consisted of 27 children that underwent 30-minute physical therapy sessions two-three times per week. Range of motion was compared at follow-up.
Twelve weeks after fracture, there was a significant greater elbow range of motion in the patients that received therapy. This improved range of motion was still present at 18-week follow-up. However, at one-year following the trauma, there was no significant difference in the range of motion in either group. A few of the children were loss to follow-up or excluded for other reasons.
This study indicates that receiving physical therapy allows a more rapid return of elbow range of motion. No adverse effects occurred from physical therapy in the therapy cohort. The end result, however, was not changed by physical therapy and the effectiveness of therapy in children remains questionable in the long term.
J Pediatr Orthop