Articular Fractures: Treatment and Rehabilitation

Abstract

Fractures of the elbow are a relatively rare event representing about 2 % of all fractures and the main part of these are intraarticular ones involving the distal humerus and the radial head. A damage to the capsular and ligamentous articular structures often coexist due to the traumatic events responsible for the fracture, making the rehabilitation treatment more complicated and challenging because of the large overlap with the problems of instability treatment. In the recent past several times it has attempted to treat distal humerus fractures conservatively with a technique called “bag of bones”. If this technique can be adequate for elderly patients, it is quite far to satisfy the younger ones: in this population indeed, goal of treatment will be the recovery of the widest painless range of motion as possible, a stable elbow as well as to reduce the potential development of osteoarthritis. To achieve this goal currently the treatment of choice of these fractures is surgery, leaving conservative treatment only for selected cases. So usually rehabilitator is having to rehabilitate a post-surgery elbow and to make the rehabilitation treatment appropriate and effective, is necessary that physiatrist and therapist are aware of many clinical informations about that specific patient and fracture: mechanism of trauma, surgical approach, type and stability of the synthesis, any additional surgical procedures and the state of the periarticular soft tissues. Only with these informations it can be achieved a real custom-tailored rehabilitation program safe for the patient. So it is crucial a continuous collaboration among the different professionals figures who will take care of the patient.