Radial Head Fracture Rehab Protocol

Introduction

• Indicated for non-op treatment, ORIF, excision, or radial head replacement.  Protocol must be altered based on fixation strength at surgery and surgeon preference.
• Goal:  Regain full pain-free ROM of elbow and prevent shoulder and wrist stiffness.

Phase (0 to 14 days)

• Elbow active ROM and active-assisted ROM for flexion and extension.  Goal is 15° to 105° of motion by 14 days.  Avoid flexion in pronation and any valgus loads on the elbow.  ROM should be performed with the arm adducted close to the body.
• Consider extension splinting per surgeons instruction.
• Putty/grip exercises.
• Isometric strengthening exercises for the elbow and wrist.

Phase II (15 days 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 active and active assisted supination and pronation.
• Begin light isotonic strengthening of flexion and extension.
• Maintain shoulder, wrist, hand strength and ROM.

Phase III (7-12 weeks)

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