A Comparison of Elbow Flexion and Elbow Extension on Hand Swelling after Surgery in Closed Fracture of Distal End Radius: Pilot Randomised Control Trial

Abstract

Elbow posture in reducing hand edema was rarely reported in literature. Elbow extension may promote lymphatic and venous drainage better than elbow flexion, which might lead to a better edema reduction after a surgery in an upper extremity. Twenty-four patients who required a surgery for distal end radius fracture were recruited for a pilot study and randomized into elbow flexion and extension groups. Elbow posture was set after the surgery until 48 hours postoperatively. Hand volume was measured at 24 and 48 hours postoperatively. Range of motion, quick Disabilities of Arm, Shoulder, and Hand score, and handgrip strength were recorded at 2, 6, and 12 weeks follow-up. In results, the mean edema reduction was 3.30% (std=15.36) and 14.14% (std=8.55) in the elbow flexion and extension groups, respectively. Elbow extension posture significantly reduces the size of the edema by 4.28 times as much as over the 24 hours period as what could be achieved by the elbow flexion posture (p=0.044). In conclusion, this randomized pilot study is feasible for a full-scale project for studying the elbow posture in edema reduction. Elbow posture might play an important role for reducing hand edema in postoperative protocol after a surgery in upper extremity.