Postoperative rehabilitation exercises with addition of blood flow restriction therapy following olecranon fracture: A case report

Background: The addition of blood flow restriction therapy (BFRT) to exercise in patients with olecranon fracture treated surgically has not been described in the literature.

Purpose: To describe the effects and safety of BFRT exercises in the postoperative rehabilitation of a patient with olecranon fracture.

Case presentation: A 27-year-old male with a surgically treated olecranon fracture completed a 12-week postoperative physical therapy programme. The assessment was performed at the start of rehabilitation, 4 and 12 weeks. The patient had elbow pain, decreased active range of motion (AROM), reduced handgrip strength, and limited physical function. The patient was treated with low-intensity resistance exercises with BFRT. The BFRT was applied with three exercises per stage, at 50% of the limb occlusion pressure and 75 repetitions per exercise. At discharge from physical therapy, improvements were observed in pain intensity (5.9-1.4 cm), AROM of elbow flexion (88°-137°) and extension (-22°--2°), AROM of forearm pronation (18°-68°) and supination (34°-78°), handgrip strength (8 kg-47 kg), physical function (22.9%-89.6%), and disability (72.7%-13.6%). These changes reached the minimal clinically important difference at the time of discharge for all measures, except for extension, pronation, and supination AROM.

Conclusion: The addition of BFRT to exercise was effective in improving pain, elbow, and wrist AROM, handgrip strength, function, and disability in a patient with surgically treated olecranon fracture. Despite the inherent limitations of our design, we believe these preliminary findings are compelling to warrant future investigations.