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Better function seen with home exercises vs PT for radial head, neck fractures
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Compared with formal therapy, patients who performed home exercises after sustaining a nondisplaced or minimally displaced fractures of the radial head or neck had better early function at 6 weeks.
“The term ‘treatment with benign neglect’ has been used in medicine for hundreds of years and was used to signify that the best course of treatment was doing nothing,” study co-author Kenneth A. Egol, MD, told Healio.com/Orthopedics. “In today’s changing health care landscape, it is incumbent upon physicians to help determine where to allocate limited resources when treating patients. We believe one such area is with minor elbow trauma, such as minimally displaced radial head fractures. These injuries heal reliably with no need for further intervention or expense. Patient counseling with this knowledge will allow treating doctors and patients to minimize costs with no diminution of outcome and improve patient satisfaction.”
Egol and colleagues identified 51 patents who had a nondisplaced or minimally displaced fracture of the radial head or neck. There were 25 patients who were randomized to undergo self-directed home-exercise and 26 patients were randomized to formal outpatient physical therapy. On average, the follow-up was 16.6 months, with follow-up visits at 6 weeks, 3 months, 6 months and at least 1 year. Outcome measures included DASH scores, pain, time to clinical healing and range of motion.
Results showed demographics were not significantly different between the two groups. Investigators noted that patients who performed self-directed home exercises had better function after 6 weeks compared with those who underwent physical therapy, which was demonstrated by a significantly lower mean DASH score. Investigators noted no significant differences were seen between the two treatment groups for any of the outcome measures at 3 months, 6 months and the final follow-up. – by Monica Jaramillo
Disclosure s : The authors report no relevant financial disclosures.
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