Physical Therapy or Occupational Therapy
We are unable to recommend for or against routine supervised physical or occupational therapy for patients with pediatric supracondylar fractures of the humerus.
We addressed this topic because of concerns regarding range of motion after healing of the fracture. Critical outcomes sought included range of motion after one year, stiffness, function, pain, and return to activity. A single study was found. It prospectively compared patients who received physical therapy with patients who did not. The study was randomized but not blinded and included only patients who were treated by open reduction. The study was underpowered so we could not include the one year endpoint. However, statistically significant results were seen at earlier endpoints. Patients in the physical therapy group had better range of motion at both 12-13 weeks and 18-19 weeks.
The recommendation is inconclusive since a single study of limited applicability (restricted to open reductions) with flawed design (underpowered, not blinded) was the only evidence available.