Early Mobilization, Elbow Fracture, Elbow Stiffnes
Conditions
Keywords
Upper extremity function, Elbow stiffnes, Early mobilization
Brief summary
The purpose with the study is to evalute if early mobilsation after surgery in patients vid elbow frakture-dislocation may lead to better armfunction and reduce common complications as stiffnes in the elbow. After surgery patients will be randomised to either early mobilisation (exercise treatment 3 Days after surgery) or ordinary treatment (plaster and exercise treatment 3 weeks after surgery).
Detailed description
In patients with elbow fracture in combinations with dislocation, surgery is often indicated. After surgery the ordinary standard praxis treatment is immobilisation in a plaster for 3 weeks. One common complication is stiff elbow. Stiffness in the elbow may be due to heterotopic ossification which is the abnormal growth of bone in the non-skeletal tissues including muscles or tendons. There is a prospective study that have reported positive results with early mobilisation starting two days after surgery in these patients. However, randomised clinical trials are missing. Therefore our aim was to investigate if early mobilisation may increase elbow function (increased range of motion and decreased pain) and also reduce comlications as stiff elbow compared to ordinary treatment in these patients. All patients operated with elbow fracture-dislocation at the University hospital in Linköping were asked if the wanted to participate in the study. They had thourough written and oral information about the study. If they agree to participate written informed consent was collected. After surgery patients were randomised to either early mobilisation or to ordinary treatment (standard praxis). At baseline before surgery or directly after patients filled in some background vatiables such as gender, age social status medical treatment etc They also filled in some self-adminstrated outcome measure in purpuse to evalute upper extremity function and activity and health related quality of Life. Follow ups with X ray and upper extremity function and activity were at 3 weeks 3 and 12 months with an independent observer. In beteween these follow ups patient followed the treatment regime (ordinary or early exrecise treatment) and had support from a physiotherapist.
Interventions
OTHERExperimental early mobilisation
early activ assisted exercises treatment
OTHERAktive comparator standrad treatmnet
standard treatment with a plaster 3 weeks and then active assisted exercises
Sponsors
Kalmar County Council
Jönköping county council
Region Östergötland
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
Randomised Clinical trail
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients over 18 years with elbow fracture-dislocation being operated on. \-
Exclusion criteria
* ongoing cancer and earlier radiation therapy in the study arm * neurological disease * cervcialgia or disc herniation in the neck * associated nerv or blodvessel injury * dementia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxford elbow score (OES 0-48 Points) | 12 month follow up | Evaluating pain, elbowfunction and psychological status |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Global impression of change | at three and 12 months | Patient satisfaction |
| Re-operation | in between 3 and 12 month follow up | Number of patients with stiff elbow who need re-operation |
| upper extremity activity scale (0-8) | 12 month follow up | Activity level Before and after injury |
| Range of motion | 12 month follow up | elbow range of motion measured with goniometer |
| Heterotopic ossification | 3 month follow up | Number of patients with heterotopic ossification verfified by X ray |
Contacts
Primary ContactTeresa Holmgren, PhD
Backup ContactHanna Björnsson Hallgren, PhD
Outcome results
None listed