Early Mobilization following Elbow Dislocation and Immobilization

Early Mobilization following Elbow Dislocation and Immobilization; Pheil G, Georgia College & State University: Milledgeville, GA. Background: This case presents a 16-year-old male junior high school soccer athlete. His injury occurred during a homecoming kickball game in which he hyperextended his elbow. The hyperextension resulted in an audible popping sound. Differential Diagnosis: There was an obvious deformity and swelling seen at the athlete’s olecranon process and cubital fossa. The athletic trainer identified a dislocation and reduced the humeroulnar joint on the first attempt. The athletes’ parents were immediately contacted, and he was transported to the orthopedist in town. Neurovascular assessments were WNL; X-ray confirmed proper reduction of dislocation. Treatment: The patient was prescribed a brace and a sling to be worn as immobilization for two weeks. After two weeks, the sling was discontinued, and the arm could be removed from the brace during rehabilitation. From weeks 2-4, thermotherapy and ROM began at the effected and surrounding joints. Around week 3, UBE was introduced. At week 5, full AROM and PROM were achieved as the foundation for strengthening and neuromuscular exercise progression. Progression was followed till week 8, when the athlete stopped reporting for rehab. Uniqueness: It is uncommon for elbow dislocations to be fully immobilized for two weeks, followed by progressive mobilization and RTP between 6-8 weeks. Early mobilization allowed the athlete to regain ROM and strength quickly without the limitations of extensor lag. Conclusions: The patient completed rehab with all therapeutic and functional outcomes met: no present pain or swelling, full range of motion, bilateral strength, and no limitations in ADL’s or soccer performance