Effect of Muscle Energy Technique in Children With Post Traumatic Elbow Stiffness

Elbow fractures are the most common pediatric fracture and one of the most common fractures involving the upper extremity. Although both pediatric and adult patients may suffer this type of injury, the frequency and type of fracture, as well as the treatment of these injuries, are distinct in both populations. Due to the anatomic complexity of the elbow, multiple structures including the trochlea of the humerus, the olecranon, and the radial head, may all be involved.

Radial head and neck fractures occur most frequently in children aged 7 years to 12 years. The majority of proximal radius fractures are radial neck fractures (89%), and these fractures occur more frequently in younger patients compared to radial head fractures. A concomitant fracture occurs in up to 39% of radial head or neck fractures, and can easily be missed on the initial interpretation of the radiographs.

Children with a proximal radius fracture present with symptoms of pain and limited range of motion after a fall or other type of trauma. Patients generally refuse to move the affected elbow. In some cases, pain may be referred to the wrist. Physical examination shows swelling, and pain exacerbated by motion, particularly with attempted pronation and supination. There is tenderness on palpation of the proximal radius.

Neurovascular examination should be performed, specifically considering the posterior interosseous nerve. Attention should also be paid to soft-tissue swelling to assess the rare risk of forearm compartment syndrome.

Childhood fractures are common with a lifetime risk of 42%-64% in boys and 27%-40% in girls.