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The indications for physiotherapy after supracondylar humeral fractures in children are not clear in the literature, even in the presence of an active or passive limitation of elbow joint motion. The authors therefore performed a prospective randomized study to assess the effectiveness of physiotherapy in improving the elbow range of motion after such fractures. The authors studied two groups of 21 and 22 children with supracondylar humeral fractures Felsenreich types II and III, all without associated neurovascular deficits. All children were treated by open reduction and internal fixation with Kirschner wires inserted from the radial side of the humerus. Postoperative follow-up at 12 and 18 weeks showed a significantly better elbow range of motion in the group with weekly physiotherapy, but there was no difference in elbow motion after 1 year. In each group, one child had an extension deficit of 15 or 20 degrees. The authors conclude that postoperative physiotherapy is unnecessary in children with supracondylar humeral fractures without associated neurovascular injuries.

We conducted three studies to evaluate further the reliability and construct validity of a new self-report instrument, the Pain Distress Inventory (PDI; Osman et al., 2003, The Pain Distress Inventory: Development and initial psychometric properties, J. Clin. Psychol. 59: 767-785). In Study I, exploratory and confirmatory factor analytic results confirmed the replicability of the four-factor oblique solution of the PDI in a mixed sample of students and nonstudents. We also found strong evidence for criterion-related validity of scores on this instrument. In Study II, multisample analyses results found further evidence for equivalence of structure of the PDI across African American and Caucasian young adults. Ethnic and gender group differences were obtained on two of the PDI scale scores. Internal consistency reliability estimates on the PDI total and scale scores were good in both Studies I and II. In Study III, additional analyses of internal consistency and known-groups validity established strong support for construct validity of the PDI.