What it is
Open reduction and internal fixation restore alignment and stability after fractures of the radial head, olecranon, or distal humerus. Plates, screws, and sometimes wires hold the bone while it heals. The goal is a stable platform for early motion and reliable strength.
Rehabilitation prevents stiffness, builds strength and capacity, and restores safe function for work and sport.
What happens when it occurs
Fragments are aligned and fixed through an open approach. Early controlled motion protects the repair while preventing adhesions from forming. Progression depends on the fracture pattern and the strength of fixation.
Common causes and risk factors
- Falls onto an outstretched hand or elbow
- Cycling incidents and contact sport
- Osteoporosis in older adults
Who is most affected
Children and adults after falls and cyclists after crashes. Older adults with low bone density are at higher risk of fracture.
Typical symptoms before surgery
- Pain, swelling, and restricted motion
- Deformity in some patterns
- Inability to use the arm for a load
When to seek care
Immediately after injury, for imaging and planning. Early fixation improves alignment and function.
How we diagnose
X-rays define the fracture. CT is used for complex articular patterns. Neurovascular status is checked and monitored.
Management
- Protection with a splint, then controlled motion by protocol
- Swelling and scar care
- Progressive range for extension, flexion, and forearm rotation
- Strength for triceps, biceps, forearms, and shoulders
- Task practice and work planning
Rehabilitation milestones
Phase 1 weeks 0 to 2: protect fixation, hand and shoulder activity, assisted range as allowed.
Phase 2 weeks 2 to 6: increase range, light isometrics and endurance without stressing fixation.
Phase 3 weeks 6 to 12: active strength, grip endurance, functional drills.
Phase 4 months 3 to 6: work and sport tasks by criteria.
Readiness to progress
- Pain stable and wounds healthy
- Radiographic healing as advised
- Strength and range targets met without next-day flare
Long-term care
- Keep mobility habits to prevent stiffness
- Build strength for carrying, pushing, and pulling
- Manage bone health where relevant
Australia snapshot
- Frequent after falls and cycling incidents
- Public and private centres offer fixation and rehabilitation
- Return to work is common with a staged plan
Latest insights
Stiffness is the main risk. Early safe motion under guidance protects long-term function.
Strength returns when range is protected and workload increases are planned.
