| Passive Movement Combined with Mobilization to Improve ROM for Elbow Terrible Triad: Case Report |
| Paper ID : 1079-ISCSR3 (R2) |
| Authors |
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Fatma ElZahraa El Bayomi *1, Aly Nabil Gad2, Saeed Mohamed Zaghloul2 1Lecturer assistant at orthopedic department of the faculty of physical therapy- Ahram Canadian University 2Student in the 5th grade at the Faculty of Physical Therapy, Ahram Canadian University. |
| Abstract |
| Background: The terrible triad is a rare elbow injury that includes dislocation, radial head/neck fracture, and coronoid fracture. The authors noted a lack of knowledge regarding standardized postoperative rehabilitation protocols. Objectives: The study aims to instruct proper integrated rehabilitation, including mobilization, passive movement, positioning, and strengthening exercises to restore the full ROM of the elbow joint after a terrible triad injury. Study Design: Case Report. Case presentation: A 24-year-old male patient, a computer engineer, came to the orthopedic physical therapy out clinic at Ahram Canadian University after undergoing surgical fixation of his elbow due to a terrible triad injury of the left elbow. The elbow was immobilized at 90 degrees flexion and pronation with a posterior splint and supported in a sling. Four weeks post-surgery, started physical therapy. On initial examination, the elbow flexion ROM was 105°, the extension ROM was 70° from full extension, he was not able to supinate his forearm, and 10° of pronation. The ROM assessment was done using a universal goniometer. The rehabilitation was done with a frequency of 2 sessions/week. The treatment focuses on passive movement in extension combined with sustained mobilization held for 10 seconds and repeated till a new range is gained in the session. Then, passive movement in flexion with mobilization to increase the flexion ROM. Prolonged stretches for the capsule in the form of positioning. Strengthening exercises for elbow flexors, extensors, supinators, and pronators to save the regained ranges. Proximal stability exercises for the shoulder. Results: After 12 weeks of rehabilitation, the ROM assessment improved by 145° flexion, 2° from full extension, 85° pronation, and 65° supination. Conclusion: The key element in post-fracture fixation in terrible triad injuries is the integration of proper techniques according to the phase and the patient's response. |
| Keywords |
| Terrible Triad, physiotherapy, rehabilitation, and passive mobilization. |
| Status: Abstract Accepted |