{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:59:20Z","timestamp":1763463560257,"version":"3.45.0"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nObjectives: An effective rehabilitation program is essential to prevent joint stiffness and regain range of motion after surgical treatment of intra-articular fractures of the distal humerus. We evaluated the effect of a physiotherapy program on functional results, that involved passive resistive stretching exercises performed under axillary brachial plexus block after radiographic observation of bone union of intra-articular fractures of the distal humerus treated with open reduction and internal fixation.\\r\\nMethods: The study included 21 patients (7 females, 14 males; mean age 34\u00b15 years; range 21 to 57 years) who underwent open reduction and internal fixation for intra-articular fractures of the distal humerus. All the patients had closed fractures. Six patients had AO type C1, six patients had C2, and nine patients had C3 fractures. Surgical treatment consisted of a posterior incision, olecranon osteotomy, and fixation of the metaphyseal fragments using two reconstruction plates placed medially and laterally. Active range of motion exercises were started on the third postoperative day. To prevent early development of heterotopic ossification, passive range of motion exercises were avoided. Active stretching exercises were initiated three weeks after surgery. Upon radiographic observation of bone union, axillary brachial plexus block was performed. The physiotherapy program involved passive stretching exercises during nerve block, and active weight exercises after recovery from motor block. The catheter remained in the axillary region for three months, during which functional rehabilitation was continued 2-3 times a week on an outpatient basis. Functional results were evaluated according to the criteria of Jupiter et al. after a mean follow-up period of 31 months (range 24 to 46 months).\\r\\nResults: All fractures united within a mean of 11.9 weeks (range 9 to 17 weeks) except for one type C3 fracture. Functional results were excellent in 10 patients (47.6%), good in eight patients (38.1%), moderate in two patients (9.5%), and poor in one patient (4.8%). Two patients with a moderate outcome had associated multiple fractures in the ipsilateral extremity. Distribution of the functional results according to the type of fractures were 4 excellent, 2 good in type C1, 4 excellent, 2 good in C2, and 2 excellent, 4 good, 2 moderate, and 1 poor in C3 fractures. The mean loss of elbow extension was 16\u00b0. The mean elbow flexion, pronation, and supination were measured as 131\u00b0, 90\u00b0, and 75\u00b0, respectively. None of the patients had nonunion at the olecranon osteotomy site, superficial or deep infection, or heterotopic ossification. Three patients developed transient ulnar nerve neuropraxia that resolved spontaneously during the follow-up period. There were no complications related to axillary catheterization.\\r\\nConclusion: Following surgical treatment of intra-articular fractures of the distal humerus, a regular and pain-free physiotherapy program performed under axillary brachial plexus block on an outpatient basis increases patient compliance and enables early return to daily activities.\n\n\u00d6zet\n\nAma\u00e7: Humerus distal u\u00e7 eklemi\u00e7i k\u0131r\u0131klar\u0131n\u0131n cerrahi tedavisi sonras\u0131nda eklem sertli\u011fi geli\u015fmemesi ve hareket geni\u015fli\u011finin korunabilmesi i\u00e7in rehabilitasyonun \u00f6nemi b\u00fcy\u00fckt\u00fcr. \u00c7al\u0131\u015fmam\u0131zda, a\u00e7\u0131k red\u00fcksiyon ve internal tespit ile tedavi edilen eklemi\u00e7i humerus distal u\u00e7 k\u0131r\u0131klar\u0131nda, kaynama sa\u011fland\u0131ktan sonra, aksiler brakiyal pleksus bloku alt\u0131nda yap\u0131lan pasif zorlay\u0131c\u0131 germe egzersiz program\u0131n\u0131n fonksiyonel sonu\u00e7lar \u00fczerindeki etkisi de\u011ferlendirildi.\\r\\n\u00c7al\u0131\u015fma plan\u0131: \u00c7al\u0131\u015fmaya eklemi\u00e7i humerus distal u\u00e7 k\u0131r\u0131\u011f\u0131 nedeniyle a\u00e7\u0131k red\u00fcksiyon ve internal tespit ile tedavi edilen 21 hasta (7 kad\u0131n, 14 erkek; ort. ya\u015f 34\u00b15; da\u011f\u0131l\u0131m 21-57) al\u0131nd\u0131. T\u00fcm olgularda kapal\u0131 k\u0131r\u0131k vard\u0131. AO s\u0131n\u0131flamas\u0131na g\u00f6re alt\u0131 k\u0131r\u0131k tip C1, alt\u0131 k\u0131r\u0131k C2, dokuz k\u0131r\u0131k C3 idi. Hastalara posterior insizyon ve olekranon osteotomisi sonras\u0131nda, metafize medial ve lateralden bir \u00e7ift rekonstr\u00fcksiyon pla\u011f\u0131 ile tespit uyguland\u0131. Ameliyat sonras\u0131 \u00fc\u00e7\u00fcnc\u00fc g\u00fcnde dirsek aktif hareket a\u00e7\u0131kl\u0131\u011f\u0131 egzersizlerine ba\u015fland\u0131. Erken d\u00f6nemde heterotopik ossifikasyon geli\u015fmemesi i\u00e7in pasif hareket a\u00e7\u0131kl\u0131\u011f\u0131 egzersizi uygulanmad\u0131. Ameliyattan \u00fc\u00e7 hafta sonra aktif germe egzersizlerine ge\u00e7ildi. K\u0131r\u0131k kaynamas\u0131 radyografik olarak g\u00f6zlendikten sonra, aksiler brakiyal pleksus blokaj\u0131 uygulanarak, blokaj alt\u0131nda zorlay\u0131c\u0131 pasif germe egzersizleri, motor blokaj kalkt\u0131ktan sonra ise aktif a\u011f\u0131rl\u0131k egzersizleri uyguland\u0131. Kal\u0131c\u0131 kateter \u00fc\u00e7 ay s\u00fcreyle aksiler b\u00f6lgeye tespit edildi ve \u00fc\u00e7 ay s\u00fcreli fonksiyonel rehabilitasyon ayaktan tedavi program\u0131 ile haftada 2-3 kez uyguland\u0131. Fonksiyonel sonu\u00e7lar Jupiter ve ark.n\u0131n \u00f6l\u00e7\u00fctlerine g\u00f6re de\u011ferlendirildi. Ortalama takip s\u00fcresi 31\u00b14 ay (da\u011f\u0131l\u0131m 24-46 ay) idi. \\r\\nSonu\u00e7lar: Bir C3 k\u0131r\u0131k d\u0131\u015f\u0131nda t\u00fcm k\u0131r\u0131klar ortalama 11.9 haftada (da\u011f\u0131l\u0131m 9-17 hafta) kaynad\u0131. Fonksiyonel sonu\u00e7lar 10 hastada (%47.6) m\u00fckemmel, sekiz hastada (%38.1) iyi, iki hastada (%9.5) orta, bir hastada (%4.8) k\u00f6t\u00fc bulundu. Orta sonu\u00e7 al\u0131nan hastalar\u0131n ayn\u0131 taraf ekstremitelerinde \u00e7oklu k\u0131r\u0131klar vard\u0131. C1 tipi k\u0131r\u0131k grubunda d\u00f6rt hastada m\u00fckemmel, iki hastada iyi, C2 tipi k\u0131r\u0131k grubunda d\u00f6rt hastada m\u00fckemmel, iki hastada iyi, C3 tipi k\u0131r\u0131k grubunda iki hastada m\u00fckemmel, d\u00f6rt hastada iyi, iki hastada orta, bir hastada k\u00f6t\u00fc sonu\u00e7 al\u0131nd\u0131. Ortalama dirsek ekstansiyonu k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 16 derece, fleksiyon 131 derece, pronasyon 90 derece, supinasyon 75 derece \u00f6l\u00e7\u00fcld\u00fc. Hi\u00e7bir hastada olekranon osteotomi b\u00f6lgesinde kaynamama durumu, y\u00fczeyel ya da derin enfeksiyon ve heterotopik ossifikasyon g\u00f6zlenmedi. \u00dc\u00e7 hastada g\u00f6r\u00fclen ulnar sinir n\u00f6ropraksisi takipler s\u0131ras\u0131nda d\u00fczeldi. Aksiler kateterizasyona ba\u011fl\u0131 herhangi bir komplikasyon g\u00f6zlenmedi.\\r\\n\u00c7\u0131kar\u0131mlar: Eklemi\u00e7i humerus distal u\u00e7 k\u0131r\u0131klar\u0131n\u0131n cerrahi tedavisi sonras\u0131nda, aksiler blok sayesinde uygulanan d\u00fczenli, a\u011fr\u0131s\u0131z fizyoterapi program\u0131, hastan\u0131n hastaneye yatmas\u0131n\u0131 gerektirmeden tedaviye uyumunu ve g\u00fcnl\u00fck rutin i\u015flerine daha erken d\u00f6nmesini sa\u011flamaktad\u0131r.<\/jats:p>","DOI":"10.3944\/aott.2010.2128","type":"journal-article","created":{"date-parts":[[2010,7,15]],"date-time":"2010-07-15T04:05:54Z","timestamp":1279166754000},"page":"111-116","source":"Crossref","is-referenced-by-count":8,"title":["Utilization of axillary brachial plexus block in the postoperative rehabilitation of intraarticular fractures of the distal humerus"],"prefix":"10.5152","volume":"44","author":[{"given":"Semsi","family":"Mustafa Aksoy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seval","family":"Izdes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmut","family":"Komurcu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Bozkurt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Basbozkurt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,8]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/2367\/2324","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:56:39Z","timestamp":1763463399000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/2367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,8]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2010,1,2]]}},"URL":"https:\/\/doi.org\/10.3944\/aott.2010.2128","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"type":"electronic","value":"2589-1294"},{"type":"print","value":"1017-995X"}],"subject":[],"published":{"date-parts":[[2020,2,8]]}}}