Q: Prepare physiotherapy protocol A: The document is a valid .docx archive 21 KB. Here is the complete protocol: --- Physiotherapy Protocol - Rajveer Bhadale 7M, Left Supracondylar Humerus Fracture Post-CRPP RajveerPhysioProtocol.docx/home/daytona/workspace/physio-protocol/RajveerPhysioProtocol.docx --- X-ray Interpretation Finding ------ Pre-op 20 Apr 2026 Gartland Type III left supracondylar humerus fracture - complete displacement, extension type Post-op 20 May 2026 CRPP performed - 3 crossed K-wires in situ, satisfactory alignment on AP + Lateral Current status 4 Jun 2026 6 weeks post-op - K-wires at or near removal; entering mobilisation phase --- Protocol Summary Phase 0 - Immobilisation Weeks 0-4, K-wires in situ - No elbow ROM exercises - Finger flexion/extension, wrist AROM, shoulder pendulum - Cryotherapy and limb elevation - Parent education on compartment syndrome signs and pin site care Phase 1 - Mobilisation Weeks 4-8, post-wire removal ← Patient is here now - Heat therapy 10 min pre-exercise warm towel or paraffin wax - Active elbow flexion/extension AROM: 15 reps x 3 sets, 3x/day - Forearm supination/pronation: 10 reps x 3 sets, 3x/day - Active-assisted ROM with gentle over-pressure at end range - TENS for pain if needed; pulsed ultrasound 0.5 W/cm2 for tissue healing - Play-based activities: ball rolling, block stacking, coloring, bead threading Phase 2 - Strengthening Weeks 8-12 - Light Theraband resistance exercises - Putty/clay grip and fine motor work - Gravity-resisted elbow extension in prone - ADL training: writing, dressing, carrying school bag Phase 3 - Return to Activity Weeks 12-16 - Sport-specific drills, proprioception training - Contact sports only after surgeon clearance at week 16 --- Key Points - CONTRAINDICATED: Forced passive stretching or vigorous manipulation - causes myositis ossificans permanent stiffness - Cubitus varus gunstock deformity: monitor carrying angle at every visit; physio cannot correct it - requires surgical osteotomy if progressive - AIN/nerve injury: common in Gartland III; monitor hand intrinsic function; most recover in 3-6 months spontaneously - ROM expectation: Small extension deficit 5-10° is normal and typically resolves by 12 months - Flynn criteria for satisfactory outcome: 15° loss of motion + 15° change in carrying angle - Evidence note: Active exercises produce faster ROM recovery vs. natural recovery alone for Gartland III CRPP cases; passive manipulation is not indicated Q: Create a parent home exercise guide as a single-page quick reference A: Your credits are exhausted. Your daily credits reset tomorrow, or you can purchase a top-up for more. Q: The wire are still intact A: Your credits are exhausted. Your daily credits reset tomorrow, or you can purchase a top-up for more. Q: Prepare assessment A: Your credits are exhausted. Your daily credits reset tomorrow, or you can purchase a top-up for more.
