scholarly journals Open elbow arthrolysis for post-traumatic elbow stiffness

2020 ◽  
Vol 1 (9) ◽  
pp. 576-584 ◽  
Author(s):  
Ziyang Sun ◽  
Weixuan Liu ◽  
Juehong Li ◽  
Cunyi Fan
Keyword(s):  
Upper Limb ◽  
Conservative Therapy ◽  
Preoperative Evaluation ◽  
Diagnosis And Treatment ◽  
Elbow Stiffness ◽  
Postoperative Rehabilitation ◽  
Stiff Elbow ◽  
Post Traumatic ◽  
Elbow Arthrolysis

Post-traumatic elbow stiffness is a disabling condition that remains challenging for upper limb surgeons. Open elbow arthrolysis is commonly used for the treatment of stiff elbow when conservative therapy has failed. Multiple questions commonly arise from surgeons who deal with this disease. These include whether the patient has post-traumatic stiff elbow, how to evaluate the problem, when surgery is appropriate, how to perform an excellent arthrolysis, what the optimal postoperative rehabilitation is, and how to prevent or reduce the incidence of complications. Following these questions, this review provides an update and overview of post-traumatic elbow stiffness with respect to the diagnosis, preoperative evaluation, arthrolysis strategies, postoperative rehabilitation, and prevention of complications, aiming to provide a complete diagnosis and treatment path. Cite this article: Bone Joint Open 2020;1-9:576–584.

scholarly journals Complications of Open Elbow Arthrolysis in Post-Traumatic Elbow Stiffness: A Systematic Review

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0138547 ◽  
Author(s):  
Jiangyu Cai ◽  
Wei Wang ◽  
Hede Yan ◽  
Yangbai Sun ◽  
Wei Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elbow Stiffness ◽  
Post Traumatic ◽  
Elbow Arthrolysis

scholarly journals Total elbow arthroplasty surgery in neglected elbow stiffness post open reduction and internal fixation with plate and screw: a case report

2020 ◽  
Vol 8 (12) ◽  
pp. 4525
Author(s):  
I. Gede Mahardika Putra ◽  
Made Bramantya Karna
Keyword(s):  
Internal Fixation ◽  
Total Elbow Arthroplasty ◽  
Dash Score ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Elbow Stiffness ◽  
Postoperative Rehabilitation ◽  
Elbow Arthroplasty ◽  
Total Elbow Replacement ◽  
Stiff Elbow

Post-traumatic and post-operative stiffness of the elbow joint constitutes a significant problem since the elbow is prone to develop soft-tissue contractures and heterotopic bone formation especially if happened in dominant arm. Total elbow replacement is considered as an ultimate treatment in salvaging a stiff elbow which has failed conservative and operative therapeutic procedures to overcome the stiffness and return the elbow to an effective functional arc. A 35-year-old female came to orthopaedic outpatient clinic in Sanglah Hospital, complaining on stiffness in her right elbow since one year prior to admission. This complain was felt after she underwent internal fixation on July 19th 2016, for closed fracture right monteggia bado type-3 post internal fixation. After the surgery, she couldn’t move her elbow because of inappropriate physiotheraphy. Neglected elbow stiffness in this patient was treated surgically with total elbow arthroplasty after physiotherapy has failed to improve her range of motion over 1-year period postoperatively. This decision stated when nonsurgical treatment fails, the patient who has realistic expectations of eventual outcome and who can comply with the arduous postoperative rehabilitation program may be a surgical candidate. Total elbow arthroplasty conducted for these patients resulted in satisfying functional outcome with using quick disabilities of the arm, shoulder and hand (DASH) score improved from 81.8 to 43.2 postoperatively and no complication was reported.

scholarly journals Post-traumatic elbow stiffness: Pathogenesis and current treatments

2018 ◽  
Vol 12 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Dafang Zhang ◽  
Ara Nazarian ◽  
Edward K Rodriguez
Keyword(s):  
Treatment Options ◽  
Nonoperative Treatment ◽  
Upper Extremities ◽  
Elbow Stiffness ◽  
Open Arthrolysis ◽  
Future Directions ◽  
Manipulation Under Anesthesia ◽  
Stiff Elbow ◽  
Pros And Cons ◽  
Post Traumatic

Post-traumatic elbow stiffness is a major cause of functional impairment after elbow trauma. A stiff elbow limits patients’ ability to position their hand in space for optimal use of their upper extremities, and as such, is a frequent indication for reoperation. This article reviews current concepts on the pathogenesis of post-traumatic elbow stiffness. Current nonoperative treatment options include therapy, bracing, and manipulation under anesthesia, while operative treatment options include arthroscopic and open arthrolysis. The pros and cons of various treatment options are discussed, with a focus on the evidence supporting their use, the expected functional gains, and associated complications. Future directions in post-traumatic elbow stiffness are highlighted.

3 Months Old Post-Traumatic Stiff Elbow Following Terrible Triad Injury - A Case Report and Review of Literature

2021 ◽  
Vol 8 (31) ◽  
pp. 2919-2922
Author(s):  
Sisir Kumar Sahoo ◽  
Ganesh A ◽  
Nikhil Kumar Sureshkumar Oza ◽  
Spandan Mishra ◽  
Indraneel De
Keyword(s):  
Elbow Joint ◽  
Functional Limitations ◽  
Daily Activities ◽  
Functional Improvement ◽  
Terrible Triad ◽  
Elbow Stiffness ◽  
Range Of Movement ◽  
Open Arthrolysis ◽  
Stiff Elbow ◽  
Post Traumatic

Stiff elbow is a common problem associated with terrible triad injuries which if not managed properly can lead to significant functional limitations. Here we are describing a case of post-traumatic stiff elbow following terrible triad who presented to us after taking native treatment primarily. He was treated with open arthrolysis and prophylactic ulnar nerve decompression along with rigorous physiotherapy including dynamic splinting with hinge elbow bracing. The results were satisfactory in achieving a functional range of movement according to the patient's vocational need. This study aims to present the prompt management of post-traumatic stiff elbow case along with functional improvement postoperatively in a decisive way. Terrible triad injuries are a group of the rare and severely unstable fracturedislocations following which the chance of recurrent instability, elbow stiffness, and functional limitations increases coherently.1 To perform normal daily activities, painless motion at the elbow joint is very much necessary and critical. Following a traumatic insult, a cascade of events can lead to a decrease in the normal arc of motion and also cause stiffness of the elbow joint.2 Over the last two decades, there has been a lot of speculation revolving around the management of terrible triad injuries.3 Van Riet et al had documented that the majority of the terrible triad injuries need to be managed surgically whereas the non-operative treatment is reserved for a few selected cases. 4 The ones which were not managed adequately had higher chances of turning up into stiff elbow. Post-traumatic elbow stiffness is one of the dreaded complications following terrible triad injuries.3 The aim of managing the case of post-traumatic stiff elbow is to have a painless, near-normal range of motion which can help the patient to do daily activities by himself. We are presenting a case of post-traumatic type- 4 stiff elbow following native bandage treatment and how prompt management has led to satisfactory results.

scholarly journals Short-term effect of ultrasound therapy on stiffness elbow joint

2019 ◽  
Vol 12 (25) ◽  
pp. 89-93
Author(s):  
Fezaa Sh. Neda
Keyword(s):  
Elbow Joint ◽  
Ultrasound Therapy ◽  
Joint Movement ◽  
Elbow Stiffness ◽  
Range Of Movement ◽  
Stiff Elbow ◽  
Wide Range ◽  
Post Traumatic ◽  
Movement Angle ◽  
Flexion And Extension

Elbow stiffness is hard to treat and commonly resulted from trauma or degenerative arthritis. This study aimed to demonstrate the effectiveness of using ultrasound therapy in management of stiff elbow joint resulted from several etiological factors. A total number of 42 patients (35 male and 7 female) allocated randomly from the Department of Physiotherapy at Al-yarmouk Teaching Hospital during 2013. Each patient examined physically by physiotherapist taking in consideration the measurement of the joint movement angle using goniometer in flexion and the extension, and the pain score using visual analogue scale (VAS). Ultrasound therapy initiated thrice weekly for two weeks. At the time of entry, the means degree of flexion and extension movements were 148.45 and 113.33º. Ultrasound therapy significantly reduced the pain from of 1.238±0.932 to 0.38± 0.538score. Significant improvement observed in patients aged more than 20 years and the improvement in flexion elbow significantly correlated with the frequency of ultrasound. In Conclusions ultrasound therapy is safe, effective and provided pain relieve as well as wide range of movement in post-traumatic elbow stiffness.

scholarly journals Outcomes of Post-traumatic Stiff Elbow Arthrolysis

2020 ◽  
Vol 10 (1) ◽  
pp. 75-81
Author(s):  
Erdem Özden ◽  
Kahraman Öztürk ◽  
Bilal Birkan Demir ◽  
Ahmet Utku Gürün ◽  
Murat Demiroğlu ◽  
...  
Keyword(s):  
Stiff Elbow ◽  
Post Traumatic ◽  
Elbow Arthrolysis

scholarly journals FRI0617-HPR GRADED MOTOR IMAGERY IN POSTTRAUMATIC STIFFNESS OF THE ELBOW: A PILOT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 913.2-914
Author(s):  
T. Birinci ◽  
E. Kaya Mutlu ◽  
S. Altun
Keyword(s):  
Pilot Study ◽  
Motor Imagery ◽  
Upper Limb ◽  
Exercise Program ◽  
Control Group ◽  
Elbow Fracture ◽  
Stiff Elbow ◽  
Limb Fractures ◽  
Upper Limb Fractures ◽  
Graded Motor Imagery

Background:Elbow fracture is treated either conservatively or surgically followed by a period of immobilization with casting or splinting. A splint used to immobilize upper limbs for many weeks results in changes in both the peripheral musculature and the central nervous system. It is well known that common complaints after upper limb fractures include weakness, pain, and stiffness; therefore, pain management is important in the early stages of the rehabilitation of upper limb fractures.Objectives:This pilot study aimed to investigate the efficacy of graded motor imaginary (GMI) on pain, range of motion (ROM), and function in patients with posttraumatic stiff elbow.Methods:Fourteen patients with posttraumatic stiff elbow (6 women, mean age: 45.42 ± 11.26 years, mean body mass index: 24.29 ± 3.38 kg\m2and mean duration of immobilization: 4.75 ± 1.03 weeks) were randomly allocated to either GMI or control groups. The GMI group received GMI treatment in addition to a structured exercise program, and the control group received a structured exercise program (two days per week for six weeks) (Figure 1). The assessments included pain at rest and during activity using the visual analog scale (VAS), elbow active ROM with a digital goniometer (Baseline Evaluation Instrument, Fabrication Enterprises, Inc., White Plains, NY), and upper extremity functional status using the Disability of the Arm, Shoulder and Hand Questionnaire (DASH). The assessments were performed at baseline and after the 6-week intervention.Figure 1.Graded motor imagery performed with mirror boxResults:After the 6-week intervention, there was a significant increase in elbow flexion-extension ROM and supination-pronation ROM, and improvement in DASH score in both groups (p<0.05). However, improvement in VAS-rest and VAS-activity was significantly higher in the GMI group than the control group (p=0.03 and p=0.01, respectively).Conclusion:A conservative treatment program consisting of GMI treatment in addition to a structured exercise program applied twice a week for 6 weeks, has been found more effective in decreasing pain in the posttraumatic stiff elbow. It could be concluded that GMI is an effective treatment method for elbow fracture in patients with predominant elbow pain.References:[1] Harris JE, Hebert A. Utilization of motor imagery in upper limb rehabilitation: a systematic scoping review. Clin Rehab. 2015:29(11):1092-1107.[2] Opie GM, Evans A, Ridding MC, Semmler JG. Short-term immobilization influences use-dependent cortical plasticity and fine motor performance. Neuroscience. 2016:330:247-256.[3] Birinci T, Razak Ozdincler A, Altun S, Kural C. A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial. Clin Rehab. 2019:33(2):241-252.Acknowledgments:The present work was supported by the Scientific Research Projects Coordination Unit of Istanbul University-Cerrahpasa (Project No: TDK-2019-33997).Disclosure of Interests:None declared

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