Abstract
We compared two protocols of early mobilisation for minimally displaced radial head
fractures through a single-blinded, prospective randomised trial. Sixty patients were
randomly allocated to either immediate active mobilisation or 5-day delay before active
mobilisation was commenced. Patients were reviewed at 7 days, 4 weeks and 3 months
after injuries. A blinded observer assessed each patient. All fractures united by
the third month. At the end of 7 days, the mobilisation group had less pain (visual
analogue scale (VAS) 6 versus 7.6, P=0.002); greater flexion (mean 112 versus 98°, P=0.0004); greater strength in supination (P<0.001) and better elbow function (Morrey Score: 54 versus 43, P=0.005). By the fourth week, both groups were comparable in all parameters and improvement
continued into the third month. Mean limit of extension at the third month were 2.3°
in the immediate mobilisation group and 1.8° in the delayed group (NS). All had excellent
function on the basis of the Morrey Score. Immediate mobilisation did not adversely
affect the outcome; the patients had less pain and better elbow function at 1-week
post-injury. Pain, ranges of movement and function were similar by the fourth week
post-injury.
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Article info
Publication history
Accepted:
May 22,
2002
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
