Department of Trauma and Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece.
J Orthop Trauma. 2013 Mar;27(3):134-9. doi: 10.1097/BOT.0b013e31825cf765.
We compared 2 different protocols of early mobilization with a protocol of delayed mobilization in patients with simple radial head fractures (B2.1 type of Orthopaedic Trauma Association Classification). An attempt to correlate certain characteristics of the radial head fractures with outcome was made.
Prospective randomized comparative study.
Level 1 trauma center.
PATIENTS/PARTICIPANTS: One hundred eighty consecutive patients were randomly allocated into 3 different protocols.
In the first group, immediate mobilization of the elbow joint was applied. In the second, a sling was used for 2 days and then active mobilization was introduced. The third protocol represented the control group where immobilization in a cast for 7 days before the mobilization was applied.
Broberg and Morrey score, The American Shoulder and Elbow Surgeons-Elbow score, visual analogue scale, and grip and pinch strength were evaluated.
The 2 protocols introducing early mobilization resulted in better outcome compared with immobilization. The first protocol resulted in worse pain in the first 3 days. Range of motion, strength, and functional outcome was better in patients allocated to the second protocol. These differences were more evident in displaced fractures. A fragment displacement of more than 4 mm and an angulation of more than 30 degrees proved to impair outcome.
Early mobilization of simple radial head fractures seemed to be a safe and an effective treatment option. It seems that a delay of 48 hours before early mobilization could be advantageous. Individualization of treatment in accordance to the characteristics of fracture could be a decisive factor for outcome.
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
我们比较了两种不同的早期活动方案与延迟活动方案对桡骨头简单骨折（OTA 分类 2.1 型）患者的效果。尝试将桡骨头骨折的某些特征与结果相关联。
前瞻性随机对照研究。
1 级创伤中心。
患者/参与者：180 例连续患者被随机分配到 3 个不同的方案中。
第 1 组立即活动肘关节。第 2 组使用吊带 2 天，然后开始主动活动。第 3 组为对照组，在应用活动前先将骨折固定在石膏中 7 天。
Broberg 和 Morrey 评分、美国肩肘外科医师-肘评分、视觉模拟评分、握力和捏力。
两种早期活动方案的结果优于固定组。第 1 组在前 3 天疼痛更严重。接受第 2 组方案的患者活动范围、力量和功能结果更好。这些差异在移位骨折中更为明显。骨折块移位超过 4 毫米和角度大于 30 度会影响结果。
早期活动桡骨头简单骨折似乎是一种安全有效的治疗选择。似乎在早期活动前延迟 48 小时可能会有优势。根据骨折的特点进行个体化治疗可能是结果的决定性因素。
治疗水平 I。请参阅作者说明以获取完整的证据水平描述。
