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Elbow Extension Range of Motion Reporting in the Olecranon Fracture Literature
Joydeep Baidya, BS
1, Gregorio Baek, BS
1, Nicholas B. Pohl, M.D.
1, Ameera Syed, BS
1, Emilie Sawicki, BS
1, Robert J. Oris, BS
1, Madeline Tadley, MD
2, Pedro K Beredjiklian, M.D.
1; Daniel J. Fletcher, M.D.
1(1)Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, (2)Rothman Orthopaedic Institute at Thomas Jefferson, Philadelphia, PA
Introduction: Flexion, supination, and pronation at the elbow are measured and reported in the olecranon fracture literature in a standardized manner using degrees of motion, but extension is variable in nature due to the utilization of multiple different methodologies. The authors hypothesize that when systematically reviewed, more than three different methods for reporting range of motion (ROM) would be found, with one being superior in effectiveness.
Materials and Methods: The PubMed and Embase databases were searched using relevant keywords. Inclusion criteria were articles on olecranon fracture management reporting elbow ROM in degrees. Two reviewers screened articles using titles and abstracts, and then reviewed full texts to assess eligibility. Variables of interest included methodology for measuring ROM, whether the study explicitly stated its ROM measuring method, interobserver and intraobserver reliability, and sensitivity and specificity of ROM measuring method.
Results: Following the application of all inclusion and exclusion criteria, 152 articles were eligible. 26 of these used multiple methods to report elbow extension, leading to 181 instances of ROM reporting. The methods that were found included Full ROM, Arc of Motion, Extension Lag, Negative Degree Elbow ROM, and Others. Full ROM (57.5%) and Arc of Motion (19.9%) were most commonly used. Only 42.4% of included studies stated their elbow extension measuring method. Stratification by study design and ROM method revealed similar patterns of varied reporting.
Conclusion: Our study reveals substantial heterogeneity in the methods utilized to report elbow extension ROM, with the most common methods being Full ROM and Arc of Motion. This lack of standardization hinders the ability to compare outcomes across studies and complicates the clinical interpretation of ROM data. Thus, the authors recommend standardizing the reporting methodology, particularly through the consistent use of the Full ROM system (0-145 degrees), to improve clinical and research comparability.
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