LI Haibo 1 , WANG Yue 2 , CHE Zheng 1 , GOU Yongsheng 1 , XU Lin 1 , LU Bing 2
  • 1. Department of Orthopaedics, the First People’s Hospital of Shuangliu District, Chengdu Sichuan, 610200, P.R.China;
  • 2. Department of Orthopedics, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu Sichuan, 610072, P.R.China;
GOU Yongsheng, Email: 15002828117@163.com
Distal humeral fracture; internal fixation; functional exercise; joint immobilization
10.7507/1002-1892.201701021
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Objective  To investigate the effect of functional exercises at different time and different immobilization positions on the functional recovery of elbow joint with type C distal humeral fractures. Methods  A total of 120 patients with type C distal humeral fractures admitted to the hospital between June 2013 and July 2015 were included in the study. They were randomly allocated to 3 groups, 40 patients in each group. Group A: functional exercises began immediately after the operation; Group B: the affected elbow was fixed at 90° flexion for 1 week and then began functional exercises after 1 week of immobilization; Group C: the affected elbow was fixed at 30° extension for 1 week and then began functional exercises after 1 week of immobilization. There was no significant difference in gender, age, fracture pattern, fracture side, injury time, and surgical approach between groups (P>0.05). Results  In groups A and B, 1 case had incision redness and swelling respectively, and the other incisions healed by first intention. Five patients occurred myositis ossificans in group A, 4 cases in group B, and 5 cases in group C. The incidence of complications in groups A, B, and C was 15.0% (6/40), 12.5% (5/40), and 12.5% (5/40), respectively. There was no significant difference between groups (χ2=0.144, P=0.930). All patients were followed up 6-25 months, with an average of 9.8 months. At 2 weeks after operation, the Mayo elbow joint function score of group A was significantly higher than those of groups B and C (P<0.05), and the visual analogue scale (VAS) of group A was significantly lower than those of groups B and C (P<0.05). There was no significant difference between groups B and C (P>0.05). At 6 months after operation, there was no significant difference in Mayo elbow joint function score and VAS score between groups (P>0.05). At 2 weeks and 6 months after operation, the flexion and extension activities of elbow joint in groups A and C were better than that in group B (P<0.05), and there was no significant difference between groups A and C (P>0.05). There was no significant difference in forearm rotation between groups (P>0.05). All fractures of 3 groups achieved clinical healing, and there was no significant difference in healing time between groups (P>0.05). Conclusion  Early functional exercises can relieve pain and obtain better elbow flexion and extesion activities after operation. The elbow joint fixed at 30° extension is better than at 90° flexion in elbow flexion and extension activitis.

Citation： LI Haibo, WANG Yue, CHE Zheng, GOU Yongsheng, XU Lin, LU Bing. Effect of functional exercise at different time and different immobilization positions on functional recovery of elbow joint with type C distal humeral fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 946-951. doi: 10.7507/1002-1892.201701021 Copy

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