Distal Humerus ORIF

Phase I: Early ROM & Protect Fixation (0 to 4 weeks)

• Splint and postop dressing remains in place for the first 2 weeks.
• Hinged Elbow Brace worn at all times (after the initial dressing removed)
• Initiate elbow exercise program 5 times per day:
• Passive extension to 0 degrees as tolerated
• Active flexion to 90 as tolerated
• Progress to full Supination/Pronation
• Shoulder/wrist/hand exercises encouraged
• Edema control
• Avoid active elbow extension x 6 wks postop
• Grip and wrist/hand AROM immediately.
• Perform supination ROM only with the elbow flexed to 90 degrees.

Phase II: Advance ROM and function (4-6 weeks)

• Passive extension to 0 degrees as tolerated
• Active/Passive flexion may increase by 10 degrees per week as tolerated
• Progress to full Supination/Pronation
• Progress to active/active assist ROM
• Begin wrist, forearm, and hand/finger strengthening exercises

Phase III: Full ROM and function (6-10 weeks)

• Wean from brace once fracture healing on XRAY (6-8 wks)
• May begin static progressive splinting if failure to achieve >100 degree arc ROM by 8 wks
• Begin active elbow extension
• Progress with strengthening slowly
  • -5 lbs lifting restriction at 6 wks
  • -15 lbs lifting restriction at 8 wks
• Transition to HEP by 8-10 wks

Phase IV: Full ROM and function (10-12+ weeks)

• Gradually return to light activity and exercise
• No further activity restrictions after 12 weeks

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