In July of 1996, Eartha Wright, along with her family, attended
a community fair. On the way back to the car, Eartha stumbled
on a cement parking block and landed on her left elbow, causing
a radial head fracture. She then had a closed reduction and
was put in a fracture brace for four weeks, leaving her with
only 45° of extension in her elbow and a complete lack of
A full two months of occupational therapy followed and even
though Eartha was very diligent in keeping all appointments with Bill (the OT), little progress was made
on increasing ROM. "Aggressive therapy didn't work... three
times a week wasn't enough", says Eartha. "The time he (OT)
put into it, would never have been enough". Bill then decided
that Eartha would be a good candidate for Ultraflex therapy
and referred Eartha to Frank Caruso, CO., who had extensive
experience with Ultraflex® custom orthoses.
On February 19, 1997, Frank fitted Eartha with a left Ultraflex®
custom- molded bi-directional EO with SupronationTM. Initial
elbow extension was -15° passive extension & -40°
active extension and supination at about -7O° PROM & AROM.
Frank Caruso had Eartha wear the Ultraflex® 8 hours/day
with tension setting at "2".
Her two week follow-up on march 5, 1997, showed good progress.
Measurements taken showed -7° ext. PROM (a gain of 8°),
ext. AROM at -15° (a gain of 25°) and supination at
-5O°. At this time, Frank Caruso decided to increase tension
Eartha continued her 8 hr./day regimen.
March 26, 1997, Eartha returned to Frank's office complaining
of pain at the elbow and only was able to wear the Ultraflex®
for 6 hours per day. Extension ROM was measured at -6°
Frank then backed the tension down to "2", but increased the
wearing time to 8-10 hours per day. This enabled Eartha to
be totally compliant. "The tension was perfect, it was working
without changing it!" she said.
Final follow-up on May 1, 1997 showed Eartha attaining both
PROM & AROM of elbow extension at -4° a gain of 11°
passively and 36° actively. Supination increased to -10°
passively and actively for a 60 degree increase in active
"Eartha's case clearly shows Ultraflex® gives you the
ability to adjust treatment to effect and maintain positive
ROM," says Frank Caruso. "Her case further validates the fact
that time, duration of use and low load stretch are the factors
that directly increase ROM and limb function. This was evident
in the fact that at a "2" tension setting, Eartha could wear
her Ultraflex® for 8 hours pain free, but when I increased
it to "2.5", she could only wear it for 6 hours with increased
Although it was a long and sometimes painful recovery for
her arm, Eartha reports being able to do all the things she
was doing previous to her accident.