No Physical Therapy for Radial Head Fractures?

Have a radial head fracture? No time for formal physical therapy (PT)? According to a new study that might be just fine.

The research, “Minimally Displaced, Isolated Radial Head and Neck Fractures Do Not Require Formal Physical Therapy: Results of a Prospective Randomized Trial,” appears in the April 18, 2018 edition of The Journal of Bone & Joint Surgery.

Kenneth Egol, M.D., vice chair for education at the New York University Hospital for Joint Diseases and study co-author, told OTW, “As physicians, we should always be looking at the treatments we prescribe for our patients. We are obligated to provide the highest quality, fiscally responsible care we can. This study identifies one area in which we as providers of musculoskeletal care can accomplish this goal.”

The authors wrote, “Patients who had a nondisplaced or minimally displaced fracture of the radial head or neck and presented to 1 of 2 providers were enrolled prospectively between January 2014 and August 2016. Patients were randomized to receive outpatient PT or perform self-directed home exercise….”

Dr. Egol commented to OTW, “We were finding that patients who didn’t have time for PT did as well as those who did PT at home (for this particular injury). So, we decided to look at it scientifically.”

The authors wrote, “At 6 weeks, the home-exercise cohort had better function as indicated by a significantly lower mean DASH [Disabilities of the Arm, Shoulder and Hand] score compared with the PT cohort. At 3 months, 6 months, and final follow-up, there were no significant differences between cohorts for any outcome measure.”

Dr. Egol told OTW, “When seeing patients with this injury, physicians can counsel them that they will generally have a full recovery with little time lost from their daily lives.”