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veghed -> rehab S/P ORIF for 2 year old? (May 23, 2003 6:58:00 PM)
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Does anyonce have any information regarding necessity and efficacy of P.T. for children after fractures and/or ORIF?
Here's the scenario:
I had a 2-1/2 year old referred for P.T. by his pedicatrician. The child had broken his elbow and had surgery about 2 months prior, and had the cast off for about 2 weeks when he had seen the pediatrician. Mom and the pediatrician were concerned that he was not using his arm.
So I evaluated the kid (about 1 week later), and found that he did no weightbearing through the arm, Elbow AROM was 80 degrees to 120 degrees. He was extremely sensitive to any touch, putting his arm in bath water, etc. He also used that arm for very little. Scapular and elbow extension strength was also decreased.
I recommended P.T., but called and then E-mailed the orthopedic surgeon to find out any precautions. (Mom said that she was told only to "not let him climb or jump").
I was told that P.T. was not necessary. The ortho. said that he had never seen a child who had ROM restrictions after an elbow injury. He said "do what you want", but refused to give any guidelines/restrictions.
I tried to do some research but came up with little. I saw the child, and he is now doing extremely well.
So...does anyone agree with this--would this kid have been okay without P.T.?
Would you have contacted the surgeon for guidance?
Do you think the surgeon appropriately declined further involvement?
Thanks for any input.
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