Post-treatment Management
- The care and precautions related to immobilization devices for the capitellar fracture must be carefully reviewed with the patient. Patients should be educated regarding care and precautions. Patients should know that pain, especially increasing pain, numbness, tingling, skin irritation, splint loosening, or excessive tightness are red flags and should be reported to the surgeon or his team.
- Pain should be managed with properly fitting splints and casts, reassurance, elevation, ice in the initial post-fracture period, and mild pain medications. Patients should be encouraged to discontinue pain medication as soon as possible. Opioid use should be kept to a minimum.
- Joints that are splinted for closed stable fractures are usually mobilized as early as possible.
- Fractures that undergo stable internal fixation can typically be mobilized after 1-2 weeks if soft tissue healing is adequate.
- After surgery, the elbow is splinted in a stable position for 2 weeks, after which the patient can begin moving the joint. The integrity of the LCL and MCL should be evaluated and used to create a ligament-specific rehabilitation protocol. Unrestricted ROM can begin at 6 weeks, and then progressive strengthening at 8–10 weeks after surgery so long as there is evidence of fracture healing.1