Radial Head ORIF

PHASE I: Early ROM & Protect Repair (0 to 2 weeks)

• Splint and postop dressing remains in place for the 10-14 days.
• Hinged Elbow Brace worn at all times (after the initial dressing removed)
• Avoid varus/valgus forces across the elbow until 3 months postop.
• Initiate elbow exercise program 5 times per day:
• Passive and active elbow ROM to as tolerated:
  • Flexion/extension
• ROM by end of 2nd week should be at least 15 to 105 degrees
• Begin putty/grip exercises
• Begin isometric strengthening exercises for the elbow and wrist
• Grip and wrist/hand AROM immediately.

PHASE II: Increase ROM and function (2 to 6 weeks)

• Continue elbow active and active assisted ROM exercises. Full flexion and extension ROM should be achieved by the end of 6 weeks.
• Begin passive and active supination and pronation as tolerated.
• Begin light isotonic strengthening of flexion and extension
• Assess and maintain shoulder and wrist strength and ROM

Phase III: Full ROM and function (>6 weeks)

• Full pronation and supination should be achieved by the end of the 8th week.
• Progressively increase isotonic strengthening in flexion/extension and pronation/supination.
• Work on any deficits.

Nonoperative Radial Head Fracture

Phase I: Immobilization (3-7 days)

Sling should be worn for comfort for only 3-7 days.

• Grip and wrist/hand AROM immediately.
• Begin putty/grip exercises

Phase II: Early ROM (1 to 2 weeks)

• Remove sling at all times
• Initiate elbow exercise program 5 times per day:
  • Passive and active elbow ROM as tolerated:
    • flexion/extension/pronation/supination
  • ROM by end of 2nd week should be at least 15 to 115 degrees
  • Begin putty/grip exercises
  • Begin isometric strengthening exercises for the elbow and wrist

Phase III: Increase ROM and function (2 to 6 weeks)

• Continue elbow active and active assisted ROM exercises.
• Full flexion and extension should be achieved by the end of 6 weeks.
• Begin light isotonic strengthening of flexion and extension
• Assess and maintain shoulder and wrist strength and ROM

Phase IV: Full ROM and function (>6 weeks)

• Full pronation and supination should be achieved by the end of the 8th week.
• Progressively increase isotonic strengthening in flexion/extension and pronation/supination.
• Work on any deficits.

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