This document, authored by Jared T. Lee, MD, outlines a rehabilitation plan for patients following a Radial Head ORIF (Open Reduction Internal Fixation) procedure.
The document is divided into four phases:
- **Phase 1 (Weeks 0-2):** Focuses on protecting the repair with a posterior arm splint. Restrictions include no lifting more than 3 lbs and limited shoulder external rotation. Therapeutic exercises include unrestricted hand and finger ROM, shoulder ROM (avoiding external rotation), and neck ROM and stretching.
- **Phase 2 (Weeks 2-6):** Transitions to a hinged elbow brace or removable splint, with the brace set between 30-90 degrees. Restrictions include no lifting more than 3 lbs and wearing the brace at all times except for hygiene and PT. Therapeutic exercises involve passive, active, and active-assisted range of motion, scar mobilization, elbow extension isometrics, light scapular strengthening, and shoulder rehab.
- **Phase 3 (Weeks 6-12):** Discontinues the orthosis, aiming for full range of motion. Restrictions include no lifting objects greater than 10 lbs. Therapeutic exercises involve full range of motion without resistance, progressed scapular strengthening, PNF patterns, eccentric elbow strengthening, isotonic forearm and wrist program, UBE biking, and plyometrics.
- **Phase 4 (Weeks 12-18):** Focuses on progression of functional activities and sport-specific activities. Restrictions include no heavy weightlifting until 16 weeks. Criteria for discharge include strength deficit less than 10%, limb similarity index of 90% or greater, 45/50 on biomechanical functional tests (if performed), and no pain or instability. Therapeutic exercises involve a progressive strengthening program, emphasis on elbow and wrist power and flexibility, and a gradual return to sports with an interval throwing program.
