TY  - JOUR
T1  - Prospective Longitudinal Evaluation of Elbow Motion Following Pediatric Supracondylar Humeral Fractures
AU  - Spencer, Hillard T.
AU  - Wong, Melissa
AU  - Fong, Yi-Jen
AU  - Penman, Adam
AU  - Silva, Mauricio
Y1  - 2010/04/01
N1  - 10.2106/JBJS.I.00736
JO  - The Journal of Bone & Joint Surgery
SP  - 904
EP  - 910
VL  - 92
IS  - 4
N2  - Background: 
  Temporary elbow stiffness after the treatment of a supracondylar humeral fracture in a child is often a concern of parents. However, little attention has been devoted to documenting, longitudinally, the time required for motion recovery. The purpose of the present study was to provide a prospective, longitudinal evaluation of elbow motion in a large population of pediatric patients undergoing treatment of a supracondylar humeral fracture.Methods: 
  We prospectively examined 373 patients (375 fractures) who presented to our urgent care center between March 1, 2007, and September 30, 2008. On the basis of a standard protocol, patients were managed with either casting or surgery, depending on the severity of the injury, and then were followed for a minimum of seven weeks. Values of elbow flexion and extension were recorded, and the relative arc of motion was calculated as a percentage of the motion of the contralateral elbow.Results: 
  In general, following a supracondylar humeral fracture, the greatest increases in flexion, extension, and the absolute and relative arcs of motion are observed within the first month after cast removal, with a progressive improvement for up to forty-eight weeks after the injury. Age had a significant effect on the recovery of elbow motion, with patients older than five years of age demonstrating a 3% to 9% lower relative arc of motion at the follow-up points in comparison with younger patients. Similarly, patients with more-severe fractures requiring surgical treatment demonstrated a decrease in relative elbow motion of 10% (with respect to the contralateral side) at the time of cast removal in comparison with those who were managed nonoperatively.Conclusions: 
  The present study demonstrates that an initial rapid recovery in elbow motion can be expected after a supracondylar humeral fracture in a child, followed by a progressive improvement for up to one year after the injury. This motion recovery is slower in older patients and in those with more severe injuries.Level of Evidence: 
  Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.I.00736
UR  - http://dx.doi.org/10.2106/JBJS.I.00736
ER  -