Pediatric elbow dislocation and elbow fractures include supracondylar humerus fractures, humeral condylar fractures, radial and neck fractures, and proximal ulnar fractures. Following the removal of an externally fixated cast or internally fixated needle, the patient needs to actively exercise as soon as possible. Otherwise they will experience limited elbow extension, flexion, and rotation function. In severe cases, the patient is left with lingering complications (sequelae) affecting the elbow’s motor functions. It is very important to assist children in the early stages of their functional exercises.
In general, when resetting an elbow dislocation, a patient’s externally fixated cast can be removed after 2-3 weeks, at which time they must immediately start an exercise regimen. When a child has an elbow fracture (whether it requires manual reduction and an externally fixated cast or an internally fixated needle (including an indwelling or external needle)), they must start an elbow exercise regimen 3-4 weeks later (4-6 weeks at the latest).
Children are generally frightened by pain due to early training that produces pain. They also exhibit a low level of self-control and cooperation. You should explain to children in advance that striving for cooperation between family and children is psychological treatment. Reasonable arrangements for children’s participation in daily activities such as using their elbow joints helps them avoid using their healthy limb to replace the injured one during exercise. This includes encouraging children to use their injured hand to hold objects, play ball, and move things. Most patients can regain their normal functions after participating in these exercises. Patients generally do not need professional rehabilitation institutions to help facilitate these exercises. It is not recommended for parents or non-professionals to help patients with passive activities, as this will prevent secondary fractures or vigorous activities causing local hyperemia and edema, ossifying myastheniasis, later-term joint movement disorders or even rigidity.
The following is some active elbow exercise methods:
Straightened elbow exercises
Patient is in a sitting position with the elbow height at the same as the tabletop. The patient places their injured elbow on the tabletop. Fold a towel to about 125 degrees in height and pad it under the elbow. The palm is facing up with the hand holding an apple or a corresponding object that interests the patient. Instruct the patient to relax their muscles and forcibly extend their elbow to its maximum. Do this for 10 times per set with a total of 3 sets every day. The scope of extension should be gradually increased.
Elbow flexion exercises
Patient is in a sitting position with the elbow height at the same as the tabletop. The patient places their injured elbow on the table edge. The palm of their hand is facing themselves. The distal forearm of the injured limb is lying on the table edge. Using a forward movement of the body, flex the elbow forward. Do this for 10 times per set with a total of 3 sets every day. The scope of extension should be gradually increased.
Elbow rotation exercises
Patient is in a sitting position with the elbow height at the same as the tabletop. The patient places both of their forearms flat on the table with both hands making a fist. Thumb is in the neutral position. The thumb rotates inward with a forward rotation. The thumb then rotates outward with a backward rotation. Do this for 10 times per set with a total of 3 sets every day. The scope of extension should be gradually increased.
Be careful not to rush through these exercises. As long as the patient has a little bit of progress every day, most patients’ elbow function can be restored to normal. It is recommended that under a doctor’s guidance, the patient will adopt the correct methods during the movement exercises.
