Contact us at 540-667-9252 or visit us at 152 Linden Drive, Winchester, VA 22601 Sports Medicine / Fracture Care OLECRANON FRACTURE ORIF REHABILITATION PROTOCOL (TO BE GIVEN TO YOUR PHYSICAL THERAPIST) SPLINT/ BRACE ROM/ THERAPEUTIC EXERCISE PHASE I: (WEEK 0-3) • Post-op splint at all times for 1 week • Transition to hinged elbow brace locked at 90° after 1 week • Brace is unlocked only for ROM exercise (settings 0 . Early movement of the elbow is encouraged. Elbow Arthroscopy. No biceps or active elbow flexion . UCLA OUTPATIENT REHABILITATION SERVICES! Bony healing occurs usually within 6 to 8 weeks in adults. Depending on the type of fracture this is usually once able. Extension and Internal Rotation not performed until 6 weeks 4. At first, your elbow will feel stiff and painful, but it is important that Sprains, strains or dislocations may occur at the same time as a fracture. Elbow Fractures. Rehabilitation of the Elbow in the Throwing Athlete Kevin E. Wilk, PT' Christopher Arrigo, MS, PT, ATC2 lames R. Andrews, MD3 ehabilitation following an injury to the elbow is a common occur- rence in orthopaedic and sports physical therapy practice. Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. Elbow Dislocation Rehabilitation Protocol Elbow Dislocation The Elbow Joint is the most complex joint in the body. ELBOW FRACTURE (Epicondyle) Description Contact sports, such as football, hockey, and An epicondyle elbow fracture is a broken bone (fracture) in the elbow involving the attachment of the forearm muscles to the arm bone (humerus). Proximal Humeral Fracture Post-Surgical Rehabilitation Protocol (OPEN REDUCTION / INTERNAL FIXATION) General Principles: 1. There are different types of surgery performed to fix these types of fractures. (A hinged elbow brace or hard posterior elbow splint may be used to minimize varus/valgus forces of the elbow if the surgeon is concerned about the integrity of the soft tissues and Elbow Dislocation Treatment Important to check neurovascular status pre-and post-reduction, especially median and ulnar nerves Examine the wrist -DRUJ injury/Essex-Lopresti Elbow Dislocation Treatment Evaluate stability after reduction Unlike the shoulder, the elbow joint is inherently stable because of the anatomy of the articulation. Distal Radius Fracture Non-Operative Rehabilitation Protocol . As a rule both the humeral and ulnar components are cemented in, providing immediate fixation to the bone. Trusted Orthopedic Surgeon serving Winchester, VA. o Full elbow and shoulder motion in all planes to prevent joint stiffness . Fractures of the distal humerus are relatively uncommon injuries. . treatment will include a sling for the first few days for pain relief. 1 . o Overhead pulleys, table slides, wall climbs, supine wand exercises . Passive . Olecranon Fracture Rehab Protocol Introduction • Indicated for non-op treatment or ORIF. Rehabilitation Protocol Monteggia Fracture - Dislocation Phase I: Early ROM & Protect Repair (0 to 6 weeks) • Splint and postop dressing remains in place for the first week. Knee Meniscal repair protocol- Simple.pdf. Introduction Elbow fractures and dislocations cause injury to important stabilizing structures and require specific treatment in order to regain functionality of the elbow joint. Bending over to perform pendulum exercises is recommended 3 to 5 times daily. Humerus fractures generally take 6-8 weeks to heal. Elbow Dislocation Rehab Protocol Phase I: Weeks 1-4 Goals: Control edema and pain Early full ROM Protect injured tissues Minimize deconditioning Intervention: • Continue to assess for neurovascular compromise • Elevation and ice • Gentle PROM - working to get full extension • Splinting/bracing as needed Rehabilitation After Elbow Release . Knee Meniscal transplant Rehab Protocol.pdf. Internal fixation may have been performed to stabilize the fracture. . Overall Goals: 1. This means you can move the joint without causing damage. Monteggia Fracture Dislocation- ORIF Three times per day home exercise program: Goal: Avoid fracture displacement but obtain max ROM by 3 months post-operatively Phase 1: Week 0-6 This means you can move the joint without causing damage. 2. Initial Therapy Prescription for Elbow Release. Hold for at least 15 to 30 seconds. San Ramon, CA » Patient Resources » Rehab/PT Protocols » ORIF Ankle Fracture Rehabilitation Protocol Download PDF Version. • Patient education to include fracture precautions, anatomy, progression of bone healing, implications of immobilization. Stress fractures represent 0.8% of high school sports injuries Of those injuries, 2.8% involve the upper extremity Changstrom et al.2015 Olecranon is most common stress fracture in baseball Iwamoto etal.2011 Predominantly occurs in pitchers Additional upper extremity stress fractures in baseball Radial shaft Elbow Protocols Mar 03, 2020 . Goal: Regain full pain-free ROM of elbow and prevent shoulder and wrist stiffness. o Full elbow and shoulder motion in all planes to prevent joint stiffness . Phase I (0 to 14 days) • Elbow active and active-assisted flexion. Elbow Fracture: Postoperative Protocol The following guidelines should be followed when treating a patient who has suffered a fracture at the elbow. FRACTURES JOINT REPLACEMENT SPORTS MEDICINE DISTAL RADIUS/DISTAL ULNA FX ORIF PROTOCOL (Dr. Sean Griffin) Weeks 1-4 • Sling is only needed until the nerve block has worn off. Post-Operative Rehabilitation following ORIF Clavicle Fracture A broken collarbone is also known as a clavicle fracture. X-rays are used to confirm if a fracture is present and if the bones are out of place. This usually occurs in children. Shoulder & Elbow Injuries. Shoulder Replacement Surgery. • Patient education to include fracture precautions, anatomy, progression of bone healing, implications of immobilization. Initial Therapy Prescription for Elbow Release. Physiotherapy Advice Following Elbow Fracture Following your elbow fracture you should carry out the below exercise 3 times per day Wean from sling as able when you have been instructed by your consultant - allow your arm to 'swing' as you walk Avoid holding arm across body. 2. There will always be individual differences amongst patients regarding progression and tolerance of specific activities. • Protocol must be altered based on fixation strength at surgery and surgeon preference. Elbow Release Protocol Information. The rehab protocol below relates to fractures that have a strong and stable surgical repair. ORIF Ankle Fracture Rehabilitation Protocol. Continue wrist ROM exercises 6-8 x daily . Fracture Care . your browser's back button to return to this page. Physical Therapy Standard of Care: Distal Upper Extremity Fractures . The clavicle lies ORIGINAL ARTICLE Wound infection in elbow fractures: Incidence and new management protocol Guiyong Yu1 | Hong Ren1 | Aiwei Xiao1 | Juan Liu1 | Mei Li1 | Ning Zhang2 1Department of Rehabilitation, Hengshui People's Hospital, Hengshui, China 2Department of Orthopedic Surgery, Hengshui People's Hospital, Hengshui, China Correspondence Guiyong Yu, MD, Department of Rehabilitation, Hengshui People . • Weeks 0-1: No formal PT to allow wound healing. Operative Treatment of the Terrible Triad Fracture Dislocation of the Elbow . Retard muscular atrophy 4. Rehabilitation Protocols. This conditon is a type oftendinitls called medial epicondylitis or "golfer's elbow". Elbow Release Protocol Information. Progression through the protocol will depend on successful accomplishments of set milestones as In order for it to recover to its best function consistent rehabilitation is essential in order to obtain the optimal outcome after injury. Knee Patella dislocation non-operative Rehab Protocol.pdf. • Elbow is positioned in a soft posterior elbow splint @ about 60 degrees of flexion, unless otherwise specified. Commonly, fractures around the elbow in adults are treated with surgery to reduce the chance of healing problems, stiffness and arthritis. Rehabilitation Considerations Your doctor may have specifc instructions for pin care and home exercises for your elbow and forearm. Supracondylar Humeral Fracture 812.41 Elbow Fracture 813.83 Proximal Radius/Ulna Fracture 813.0 Radial Head Fractures 813.05 Olecranon Fracture 813.01 Radial/Ulnar shaft fractures 813.1 Distal Radius Fracture 813.42 Distal Ulna Fracture 813.82 Carpal Fracture 814.01 . Dr. Chad Myeroff's Rehabilitation Protocol Dr. Chad Myeroff, Shoulder and Elbow Specialist Updated: May 2019 . . Elbow Arthroplasty: Postoperative Protocols Total elbow arthroplasty is most commonly performed for rheumatoid arthritis, osteoarthritis, and fracture of the distal humerus. Decrease pain and inflammation 5. Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. Elbow Dislocation with Fracture of the Radial Head • Repeat dislocation and subluxation are . If the break heals in a poor position, there could be a significant loss of function or movement in the elbow. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the Ohio State Sports Medicine physical therapy team and sometimes, other healthcare providers. Wear the postop splint full time for 2 weeks. . The radius is one of two bones in the forearm that that extend from the wrist to the elbow. • Post-op posterior elbow splint - if applied - should be worn until first post-op visit at 7-10 days. REHABILITATION GUIDELINES FOR PROXIMAL HUMERUS FRACTURE (NON-OPERATIVE) 2 | P a g e (Phase II continued) • Precautions DC sling x 3 weeks if cleared by MD • AAROM to 90 degrees forward flexion and 40 degrees ER Suggested Therapeutic Exercises • AROM cervical, elbow, wrist and hand • Pendelums • Gripping exercises • Scapular PNF • Pulleys with eccentric control of the elbow with flexion/extension Phase III minimum protection phase: (8 weeks post fracture) Goals: Educate patient on proper joint protection and therapeutic exercises Gain adequate strength in the forearm flexors and extensors to increase stability at the elbow Cervical Fusions Lumbar Fusion. Protection of the ligament repair is essential. This information leaflet provides guidance on the amount of exercises you should aim to do once instructed the sling can be removed. Less stable fractures may require more protection and a less aggressive protocol. Initiate PROM of elbow 30-100 (greater extension is acceptable) Initiate elbow extension isometrics (sub-painful) Continue wrist ROM exercises 4-5 x daily . It is important that this be carefully carried out under the supervision of a therapist. Return to normal function and motion may require 4 months - 6 months. Elbow & Forearm Home Exercise Program. . stPo -Operative . slide 1 of 3, Elbow flexion stretch, Lift the arm that bothers you, and bend the elbow. Press your hand toward your shoulder until you feel a stretch in the back of your upper arm. No limits to early ROM which should be advanced as tolerated. DO NOT lift your arm at the shoulder using your muscles. Brace: Hinged elbow brace open to ROM as above Exercises: Continue all exercises listed above Elbow ROM 6-8 x daily Initiate active ROM Wrist and Elbow (No resistance) Continue PROM/AAROM elbow motion Elbow ROM (minimal) 15°-105° progress extension as tolerated Initiate shoulder rehab program -Tubing IR/ER -Full can -lateral raises Promote healing of ulnar collateral ligament 3. Your doctor may have specifc instructions for pin care and home exercises for your elbow and forearm. Proximal Humerus Fracture Rehabilitation Protocol Your shoulder rehabilitation program begins while you are in the hospital. . Your palm should face toward you. Clavicle Fracture (Broken Collarbone) A broken collarbone is also known as a clavicle fracture. -Splint to be worn full time except for when performing therapy exercises for the "rst 6 weeks. Spine Protocols. ELBOW OLECRANON FRACTURE ORIF PHYSICAL THERAPY Philosophy This protocol is to be utilized as a guideline. Elbow fractures may result from a fall, a direct impact to the elbow, or a twisting injury to the arm. However, relatively little has been written discussing the rehabilitative process of the injured Shoulder/Elbow Surgery Inverness Department of Orthopedics (303) 694 -3333 University of Colorado Anschutz Medical Campus (720) 848-1900 Rehabilitation Protocol Radial Head Replacement Phase I: Early ROM & Protect Repair (0 to 6 weeks) • Splint and postop dressing remains in place for the first week. Rehabilitation is essential in either the surgical or non-surgical treatment of elbow fracture-dislocations. Radial head fractures are not treated in a plaster cast, as the fracture is stable. Elbow Dislocation Stable Non-operative Treatment. Please consult with your doctor or health professional to make sure that this information is right for you. J Pediatr Orthop. Because of the need for your comfort and the protection of the repaired clavicle fracture, a Ankle Injuries. This information leaflet provides guidance on the amount of exercises you should aim to do once instructed the sling can be removed. 6. Rehabilitation Goals • Protect repair • Minimize pain and swelling • Maintain ROM of surrounding joints Your fracture . sitting, vary your arm position often Radial head fracture Coronoid fracture . Distal Radius Fracture Non-Operative Rehabilitation Protocol . Sports Medicine / Fracture Care OLECRANON FRACTURE ORIF REHABILITATION PROTOCOL (TO BE GIVEN TO YOUR PHYSICAL THERAPIST) SPLINT/ BRACE ROM/ THERAPEUTIC EXERCISE PHASE I: (WEEK 0-3) • Post-op splint at all times for 1 week • Transition to hinged elbow brace locked at 90° after 1 week • Brace is unlocked only for ROM exercise (settings 0 . Wean from brace once fracture healing on XRAY (6-8 wks) May begin static progressive splinting if failure to achieve >100 degree arc ROM by 8 wks Begin active elbow extension Progress with strengthening slowly -5 lbs lifting restriction at 6wks -15 lbs lifting restriction at 8 wks Transition to HEP by 8-10 wks Weeks 10-12+ Phase (0 to 14 days) Begin elbow active ROM and active-assisted ROM for flexion and extension. Non-Operative Proximal Humeral Fracture Rehabilitation Protocol General Principles: 1. Anatomy The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. Predictors of failure of nonoperative treatment for type -2 supracondylar humerus fractures. Always follow your doctor's instructions. FORMCHECKBOX Elbow, wrist, and hand ROM exercises FORMCHECKBOX Scapular exercises-shrugs, squeezes, and PNF . Some pain and discomfort is normal as you carry out these exercises, particularly in the frst few days after the injury or cast removal. Severity of humerus fractures can vary and affect time to healing and stability of the repair. Proximal Humerus Fracture . • At 2 weeks, patient will be placed in a removable splint up until 6 weeks postop. • Advance elbow extension with radial deviation and elbow flexion with ulnar deviation By signing this referral, I certify that I have examined this patient and physical therapy is medically necessary. At first, your elbow will feel stiff and painful, but it is important that Early movement of the elbow is encouraged. Gentle hand/wrist/elbow/shoulder stretching. WESTWOOD 1000 Veteran Ave., A level Phone: (310) 794-1323 . Continue use of wrist splint for 3-4wks. of this injury and your treatment options. Non-displaced means less than 1cm of displacement and less than 45° of angulation 2. If resting e.g. 2011;31:372. Inpatient: (0-3 days) Elbow Fracture_Dislocation Operative. Motion: Regardless of whether surgical or non-surgical treatment is performed, correct rehabilitation following diagnosis of the injury pattern is crucial to achieve the best possible outcome in each individual case. . ANCILLARY MEASURES: • Use pain medication as needed. UCL Elbow Nonoperative. While comprising nearly one-third of all elbow fractures, these injuries make up only 5% to 7% of all fractures. The protocols listed below were developed by Southeast Georgia Health System physicians and therapists and are intended for use by clinicians and patients alike. Therapeutic Exercise: Passive ROM as tolerated. These fractures result from a separation at the growth plate, the weakest link in Bony healing occurs usually within 6 to 8 weeks in adults 3. Conservative Treatment Following Ulnar Collateral Ligament Sprains Of the Elbow Phase I Immediate Motion Phase Post-Injury days 0 - 7 Goals 1. It does not replace the opinion, discussion, and treatment from a trained medical professional. Radial Head Fracture Nonoperative Treatment !erapy Instructions Laith Al-Shihabi, MD 1-2 weeks Splint: -Fashion removable long-arm splint holding the elbow in 90 degrees !exion and wrist in neutral. REHABILITATION GUIDELINES FOR PROXIMAL HUMERUS FRACTURE - ORIF PHASE I (1-3 WEEKS) DATES: Appointments • Begin physical therapy at 1 week post op, 2 x/week • Follow up with MD 10-14 days post op. RADIAL HEAD FRACTURE REHAB PROTOCOL Introduction This protocol is recommended for Mason's type I fracture or type II or III with ORIF. REHABILITATION PROTOCOL IMMEDIATE POSTOPERATIVE PHASE Protect healing tissue Decrease pain/inflammation Retard muscular atrophy Avoid strengthening the flexor mass muscle group during this initial phase to allow for healing at medial epicondyle Weeks 1-2 • Brace: 90 degrees elbow flexion • Cryotherapy: To elbow joint Elbow Fracture_Dislocation Operative. Information contained in this fact sheet is a guideline for care only. Terminal elbow extension performed with the forearm neutral or pronated until 3 months. This injury typically has a bimodal distribution occurring from either high-energy trauma in a young population or low-energy injury in the elderly. Increase ROM while protecting the fracture site. The following steps can help you have optimal recovery: Early and continuous physical therapy Adequate pain control to tolerate exercises Overuse Injuries. Please DO NOT remove this. It is very important to get your arm moving as soon as possible, to avoid joint stiffness and muscle tightness. Elbow Dislocation Stable Non-operative Treatment. Distal . This is a very common fracture that occurs in people of all ages. This is a very common fracture that occurs in people of all ages. Cryotherapy: Continue ice to elbow . These protocols are listed by diagnosis, so clinicians who are providing patient care may reference the applicable protocol to help rehabilitate their patient . Medial epicondylitis is caused by using a repetitive strong gr1P while swingmg a golf club Of racket or by usmg the wrist too mueh during these treatment will include a sling for the first few days for pain relief. 2 3 . Dr. Chad Myeroff's Rehabilitation Protocol. Fracture of the coronoid process can be either an isolated finding following elbow dislocation or part of a more complex fracture‐dislocation. Protocol W3 Physical Therapy or Occupational Therapy Protocol for Open Reduction and Internal Fixation of Distal Radius Fracture Phase I: Protection Phase (weeks 0-6) GOALS: • Reduce hand and finger swelling. Elbow, Radial Head, Distal Humerus, Coronoid Fractures Dr. Bakker's Post-op Protocol IMPORTANT INSTRUCTIONS FOLLOWING SURGERY: After surgery, your forearm and hand will be in a large bandage and plaster splint. Hip Injuries. Knee Lateral Release Rehab Protocol.pdf. your browser's back button to return to this page. Standard surgical protocol to treat elbow dislocations . Initiate light scar mobilization over distal incision . Keeping your arm at your side, bend and straighten the elbow, flex the wrist, hand and fingers. Golfer's Elbow (Medial Epicondylitis) Many racquet players and golfers develop pam on the Inner side of the elbow. • Stable elbow fractures, e.g. protocols hand therapy protocol books/guidelines: ## post surgical rehabilitation guidelines for the orthopedic clinician: hospital for special surgery %% hand and upper extremity rehabilitation: a practical guide : curtis national hand center ** diagnosis and treatment manual for physicians and therapists: upper extremity Elbow Distal Humerus Fracture - ORIF Three times per day home exercise program: Goal: Avoid fracture displacement but obtain max ROM by 3 months post-operatively Phase 1: Week 0-6 • Sling as needed for comfort Elbow Fractures. Increase ROM 2. Upper Extremity Protocols. After surgery, exercise is an essential part of rehabilitation and a key component of a successful treatment outcome. non- or minimally displaced radial head fractures, and simple elbow dislocations: o MD may clear for elbow motion within 1-3 days to minimize risk of stiffness o May not require splint immobilization- MD may order sling only • Elbow fractures managed with open reduction and internal fixation (ORIF), e.g . Always follow your doctor's instructions. 5. For terrible triads, or ORIF + ligament reconstruction, please also refer to ligament repair protocols. of this injury and your treatment options. Depending on the type of fracture this is usually once able. Coronoid Fx: Type 1 by Mayo (O'Driscoll) Classification . After closed reduction, exercises to improve range of motion must be performed. General Principles of Rehabilitation for Fractures . Early goals are to reduce shoulder stiffness and pain. Elbow Arthroscopy. Shoulder/Elbow Surgery Inverness Department of Orthopedics (303) 694-3333 University of Colorado Anschutz Medical Campus (720) 848-1900 Rehabilitation Protocol Non-operative Clavicle Fracture Phase I: Protect clavicle (Injury to 2 weeks) • Sling . Rehabilitation After Elbow Release . Elbow & Forearm Home Exercise Program. -Splint to be worn full time except for when performing therapy exercises for the "rst 4 weeks, then as needed with activities for weeks 4-6. Knee Meniscus Repair Complex Rehab Protocol.pdf. Remove splint NWB and no resisted elbow flexion or forearm supination/pronation. With your other hand, gently push on the back of your affected forearm. Olecranon Fracture Open Reduction and Internal Fixation !erapy Instructions - Early Motion Protocol Laith Al-Shihabi, MD 1 week Splint: -Fashion removable long-arm splint holding the elbow in 90 degrees !exion and wrist in neutral at 1 week post-op. This patient _____ would _____ would not benefit from social services. • Goal: Regain full pain-free ROM of elbow and prevent shoulder and wrist stiffness. Radial head fractures are not treated in a plaster cast, as the fracture is stable. the safest form of treatment for many of these fractures - Pins maintain the reduction and allow the elbow to be immobilized in a more extended position Fitzgibbons. It does not replace the opinion, discussion, and treatment from a trained medical professional. Knee Microfracture of femoral condyle Rehab Protocol.pdf. UCL Elbow Nonoperative. It is very important to get your arm moving as soon as possible, to avoid joint stiffness and muscle tightness. Radial Head or Neck Fractures (Non-displaced) Fact Sheet . • Prevent shoulder and elbow stiffness. Elbow Trauma Rehabilitation Protocol Includes post ORIF, or conservatively managed trauma when active ROM indicated N.B. Much attention has been focused on treatment of radial head fractures and lateral ligament reconstruction, although recently, attention has been directed at detection and treatment of coronoid fractures. Some pain and discomfort is normal as you carry out these exercises, particularly in the frst few days after the injury or cast removal. Elbow Distal Biceps Endobutton Repair Elbow Distal Triceps Repair - Dr. Foster Elbow LUCL Elbow Medial Epicondylar Debridement Elbow Olecranon Fracture (ORIF) Elbow UCL - Dr. Bear Elbow Ulnar Collateral Ligament Repair Elbow Ulnar Nerve Decompression Elbow Ulnar . A sling is used for comfort only. Elbow Protocols Mar 03, 2020 . REHABILITATION PROTOCOL PHASE I (0-6 weeks) Goals: Prevent active wrist extension to protect repair, maintain shoulder ROM Precautions: Immobilizer should be worn at all times for first 7-10 days. Pre-operatively on the ward • Discuss post -operative rehab ' PHASE I: 0-2 weeks: .
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