The arthroscopic assessment of the stiff elbow may be difficult with a joint capacity as little as 6 cc. Pdf the treatment of posttraumatic stiffness of the elbow. Nonsurgical treatment includes physical therapy and splinting. Open surgical release of posttraumatic elbow contracture. Management of the posttraumatic stiff elbow request pdf. Pdf progressive surgical release of a posttraumatic. The severity of the dysfunction depends on the nature of the initial trauma and the treatment used. While abundant literature on the adult post traumatic elbow contracture describes its treatment and results, the literature describing post traumatic stiffness in the pediatric and adolescent elbow is limited to small case series with varying results. Progressive surgical release of a posttraumatic stiff elbow. Surgical stiff elbow release is effective at restoring range. Elbow fracture, which is treated either conservatively or surgically, may develop a common complication known as post traumatic stiff elbow 1, 2. Arthrolysis for post traumatic stiffness of the elbow. Post traumatic elbow stiffness has been recognized to be a common and difficulttomanage condition that can interfere with patients activities and their quality of life. Post traumatic elbow stiffness can be diagnosed when range of elbow motion or rotation not meeting patient needs in entertainment, work, and daily life after a related trauma 1, 2.
Most cases improve with time and use, although significant stiffness may persist and interfere with function. Keywords post traumatic stiff elbow, open arthrolysis, arthroscopic treatment, mayo clinic performance score, dash score 1. The stiff or contracted elbow is defined as an elbow with a reduction in extension greater than 30 degrees, andor a flexion less than 120 degrees. Posttraumatic osteoarthritis of the elbow is an uncommon condition in which the clinical manifestations are often at variance with the radiological findings. Fracture malunion, callus formation, and degenerative changes are common intraarticular causes of elbow stiffness.
This article describes the development and use of an animal model to study post traumatic stiffness and contracture of the elbow. Determining the effective timing of an open arthrolysis. In other words, post traumatic shoulder stiffness covers a wide spectrum of dynamic and complex processes with different phases and severities. Posttraumatic elbow stiffness in children clinical gate. Conservative treatment up to the fourth month is not unusual, particularly in cases of stiffness that are not associated with joint deformity or heterotopic ossification. Development and use of an animal model to study post traumatic stiffness and contracture of the elbow. Unfortunately, the elbow joint is prone to stiffness following a multitude of traumatic and atraumatic etiologies. The goal of treatment is to restore a functional range of elbow motion. In addition to severe elbow pain, the stiffness from elbow arthritis can become disabling, making it difficult to perform simple activities.
Elbow stiffness after fractures or other injuries often develops and limits function. The etiology of post traumatic stiffness may be multifactorial and may include among other causes. Post traumatic elbow stiffness can range from mild to severe and may be extremely difficult for the patient because of pain and resultant limitations in activities of daily living. Elbow contracture is a debilitating complication of elbow trauma. We performed a lateral approach for the release of post traumatic stiffness of the elbow in 22 patients using a modified technique designed to spare the lateral ligaments. Pdf arthrolysis for posttraumatic stiffness of the. Elbow arthritis uw orthopaedics and sports medicine, seattle. Given the evidence that smoking is a predisposing factor for increased complications and adverse functional outcomes after different orthopedic procedures, we hypothesized that smoking would have a. Nonoperative treatment includes physical therapy, intraarticular injections with corticosteroids, and a static progressive or dynamic splinting program.
Posttraumatic contracture is a common complication after elbow trauma. Surgical treatment of posttraumatic elbow stiffness by. Posttraumatic stiffness of the elbow sciencedirect. Itamura upper extremity function is largely dependent on a functional elbow joint, as the elbow serves to position and stabilize the hand in space in addition to serving as a fulcrum for the forearm and as a loadcarrying joint. Stiff elbow is a common problem after articular trauma, causing functional impairment of the upper limb. Development and use of an animal model to study post traumatic stiffness and contracture of the elbow spencer p. The gravity of the dysfunction depends on the nature of the initial trauma and the. Posttraumatic osteoarthritis of the elbow sciencedirect. Post traumatic stiff elbow is a rather common disorder that develops after dislocation of the elbow with or without fracture, or after a fracture of the distal humerus, particularly with intraarticular involvement. Pdf mobilization brace in posttraumatic elbow stiffness.
Post traumatic elbow stiffness is a major cause of functional impairment after elbow trauma. If conservative therapy fails to restore adequate elbow motion, surgical release is recommended. Restriction of elbow motion after trauma is a wellrecognized problem. Invalidating elbow contractures, a frequent problem after injury, are commonly treated by physical therapy or surgical release. Open versus arthroscopic treatment of posttraumatic stiff. Restriction of elbow motion after trauma is a well. Elbow motion is essential for upper extremity function to position the hand in space. The combination of elbow flexion and extension, as well as forearm rotation, allows for placement of the hand for activities of daily living. To regain functional elbow motion, several conservative and surgical treatment options are available. The stiff elbow how i do it jens ole sajbjerg contracture of the elbow is a common complication of fractures, dislocations, burns, etc.
Fractures of the olecranon and radial head can also cause stiff elbows. Open versus arthroscopic treatment of post traumatic stiff elbow. Increase in arthroscopy knowledge and skills, as well as technological advances in the passed decade of years, has made arthroscopic arthrolysis a safe and reliable treatment for patients with a posttraumatic elbow. Complications of open elbow arthrolysis in posttraumatic. The study of the treatment of post traumatic stiffness of the elbow presents numerous challenges. Due to the great variability of the types of lesions, causes and symptomatology, there are great difficulties in the homogenization of protocols and in the comparison of results between the different treatments. Twelve of 14 patients who underwent arthrolysis of the elbow for post traumatic stiffness were reexamined after a mean of 62 months.
Various treatment modalities are used in addressing these contractures. The nonsurgical methods for managing post traumatic elbow stiffness consist of using joint immobilizers and physiotherapy. Posttraumatic elbow stiffness is a common problem that is often difficult to manage. Posttraumatic elbow stiffness is a disabling condition that remains challenging to treat despite improvement of our understanding of the pathogenesis of posttraumatic contractures and new treatment regimens. Debridement arthroplasty for posttraumatic stiff elbow. Introduction the normal arc of motion of the elbow is from 0 to 145 degrees of flexion 1. Development and use of an animal model to study post. The posttraumatic elbow stiffness treatment full text. The treatment of elbow stiffness is a challenged procedure due to the complicated anatomical.
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