Post-traumatic stiff elbow

Adolfsson, Lars

doi:10.1302/2058-5241.3.170062

Cited by 28 publications

(35 citation statements)

References 52 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…carried out a study on 51 patients undergoing this procedure, reporting good results. 1 , 26 The same results were obtained by Ek et al . in a study of 12 pediatric patients.…”

Section: Conservative Treatmentsupporting

confidence: 85%

“…Dynamic splints are the most used device in the treatment of early or late stiffness and are based on the viscoelastic properties of the peri-articular soft tissues to generate a certain degree of deformation in response to the application of a variable force. 17 Moderate stiffness, which has persisted for less than a year in adults due to soft tissue contractures, have been successfully treated using dynamic splints 1 . Once the pain is reduced, the device can be applied at night with serial increases in the applied voltage.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…in a study of 12 pediatric patients. 1 , 27 In children with plexus paralysis that causes elbow stiffness during flexion, the indicated treatment consists of electrostimulations and exercise. Furthermore, botulinum toxin A is indicated in the search for joint recovery.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…Elbow is a joint particularly prone to stiffness due to its anatomical and biomechanical complexity. 1 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The stiff elbow: Current concepts

Masci¹,

Cazzato²,

Milano³

et al. 2020

Orthop Rev (Pavia)

View full text Add to dashboard Cite

Elbow stiffness is defined as any loss of movement that is greater than 30° in extension and less than 120° in flexion. Causes of elbow stiffness can be classified as traumatic or atraumatic and as congenital or acquired. Any alteration affecting the stability elements of the elbow can lead to a reduction in the arc of movement. The classification is based on the specific structures involved (Kay’s classification), anatomical location (Morrey’s classification), or on the degree of severity of rigidity (Vidal’s classification). Diagnosis is the result of a combination of medical history, physical examination (evaluating both active and passive movements), and imaging. The loss of soft tissue elasticity could be the result of bleeding, edema, granulation tissue formation, and fibrosis. Preventive measures include immobilization in extension, use of post-surgical drain, elastic compression bandage and continuous passive motion. Conservative treatment is used when elbow stiffness has been present for less than six months and consists of the use of serial casts, static or dynamic splints, CPM, physical therapy, manipulations and functional re-education. If conservative treatment fails or is not indicated, surgery is performed. Extrinsic rigidity cases are usually managed with an open or arthroscopic release, while those that are due to intrinsic causes can be managed with arthroplasties. The elbow is a joint that is particularly prone to developing stiffness due to its anatomical and biomechanical complexity, therefore the treatment of this pathology represents a challenge for the physiotherapist and the surgeon alike.

show abstract

“…carried out a study on 51 patients undergoing this procedure, reporting good results. 1 , 26 The same results were obtained by Ek et al . in a study of 12 pediatric patients.…”

Section: Conservative Treatmentsupporting

confidence: 85%

Section: Conservative Treatmentmentioning

confidence: 99%

Section: Conservative Treatmentmentioning

confidence: 99%

“…Elbow is a joint particularly prone to stiffness due to its anatomical and biomechanical complexity. 1 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The stiff elbow: Current concepts

Masci¹,

Cazzato²,

Milano³

et al. 2020

Orthop Rev (Pavia)

View full text Add to dashboard Cite

show abstract

“…Recent research has increased the knowledge of the biomechanical and biochemical processes causing post-traumatic elbow stiffness but the exact mechanisms are still largely unknown. 3 Neurological assessment is imperative and the ulnar nerve is particularly susceptible to injury associated with the initial trauma. In cases with severe scarring, the normal gliding and stretching of the nerve during elbow movements may be disturbed and any procedure increasing elbow mobility may create ulnar nerve symptoms if the nerve is embedded in scar formation.…”

Section: Introductionmentioning

confidence: 99%

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

Putra

Karna

2020

Int J Res Med Sci

View full text Add to dashboard Cite

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.

show abstract

Comparative histomorphological analysis of elbow ligaments and capsule

et al. 2022

View full text Add to dashboard Cite

This study aimed to compare the histomorphology of the elbow capsule and its ligaments to gain a better understanding of the clinically relevant biomechanical stabilization. Eleven human elbows were dissected including the joint capsule with its anterior (AJC) and posterior (PJC) parts, the annular ligament (AL), the radial collateral ligament (RCL) and the ulnar collateral ligament with its anterior (AUCL), posterior (PUCL) and transverse (TUCL) parts. Hematoxylin–Eosin and Elastica van Gieson as conventional histology stainings were applied to determine collagenous and elastic fiber arrangements in transmission and polarization light microscopy. The radial collateral ligament and the anterior part of the ulnar collateral ligament showed significantly more densely packed parallel fiber arrangement than the anterior joint capsule, the posterior joint capsule, and the posterior part of the ulnar collateral ligament (p < 0.02, respectively). The PUCL had significantly more mixed tight and loose parallel arrangements than the PJC, the annular ligament, the RCL, the AUCL and the transverse part of the ulnar collateral ligamentp < 0.02, respectively), while the PJC showed significantly more interlaced mixed tight and loose fiber arrangement than the AL, the RCL and the AUCL (p < 0.003, respectively). The AJC had a significantly higher amount of elastic fibers as compared to the AL, the RCL, the AUCL and the TUCL in fascicular regions (p < 0.04, respectively), while the AUCL had significantly lesser elastic fibers than the AJC and the PJC (p < 0.004, respectively). The densely packed parallel fiber arrangement and few elastic fibers of the AUCL, RCL, and AL indicate a strong biomechanically stabilizing function. The fiber arrangement of the PUCL and the TUCL with few elastic fibers support the medial elbow stabilization. Crimping and elastic fibers provide the viscoelasticity of the joint capsule.

show abstract

Post-traumatic stiff elbow

Cited by 28 publications

References 52 publications

The stiff elbow: Current concepts

The stiff elbow: Current concepts

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

Comparative histomorphological analysis of elbow ligaments and capsule

Contact Info

Product

Resources

About