Research Article| Volume 5, ISSUE 4, P209-216, November 2005

Elbow Stiffness: Etiology, Treatment, and Results

      Elbow stiffness is a common problem after trauma to the elbow. The goal of treatment should be to achieve a functional range of motion (30°–130°). Nonsurgical options are physical therapy and splinting. Surgical options depend on the degree of degenerative change in the elbow joint. With mild to moderate degenerative changes, procedures such as soft-tissue releases, debridement, and Outerbridge-Kashiwagi arthroplasties may be performed either open or arthroscopically. With more severe degenerative changes, the options are more limited depending on the age and activity level of the patient.
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        • Zagorski J.J.
        • Burkhalter W.E.
        • Uribe J.W.
        Comminuted intraarticular fractures of the distal humeral condyles. Surgical vs. nonsurgical treatment.
        Clin Orthop. 1986; 202: 197-204
        • Jupiter J.B.
        • Goodman L.J.
        • Saldana A.E.
        Multiplane fracture of the distal humerus.
        J Orthop Trauma. 1993; 7: 216-220
        • Mehlhoff T.N.
        • Bennett J.B.
        • Tullos H.S.
        Simple dislocation of the elbow in the adult. Results after closed treatment.
        J Bone Joint Surg. 1988; 70: 244-249
        • Broberg M.M.
        Results of treatment of fracture-dislocations of the elbow.
        Clin Orthop. 1987; 216: 109-119
        • Morrey B.F.
        • Askew L.J.
        • Chao E.Y.
        A biomechanical study of normal functional elbow motion.
        J Bone Joint Surg. 1981; 63: 872-877
        • Morrey B.
        The Elbow and its disorders. 2nd ed. WB Saunders, Philadelphia1993
        • Morrey B.
        Post-traumatic contracture of the elbow.
        J Bone Joint Surg. 1990; 72A: 601-618
        • Kay N.
        Surgery of the elbow. Edward Arnold, London1998
        • Bruno R.L.
        • Strauch R.J.
        • Rosenwasser M.P.
        Post-traumatic elbow stiffness.
        J Am Acad Orthop Surg. 2002; 10: 106-116
        • Green D.M.
        • Turnbuckle H.
        Orthotic correction of elbow-flexion contractures after acute injuries.
        J Bone Joint Surg. 1979; 61A: 109
        • Gelinas J.J.
        • et al.
        The effectiveness of turnbuckle splinting for elbow contractures.
        J Bone Joint Surg. 2000; 82: 74-78
        • Greis P.H.
        • Plancher K.D.
        Arthroscopic removal of loose bodies of the elbow.
        Orthop Clin North Am. 1995; 26: 679-689
        • Robla J.H.
        • Uribe J.W.
        • Phillipon M.S.
        Chondromalacia of the trochlear notch in athletes who throw.
        J Shoulder Elbow Surg. 1996; 5: 69-72
        • O’Driscoll S.W.
        Operative Treatment of elbow arthritis.
        Curr Opin Rheumatol. 1995; 7: 103-106
        • Ball C.M.
        • Galatz L.M.
        • Calfee R.
        • Yamaguchi K.
        Arthroscopic treatment of post-traumatic elbow contracture.
        J Shoulder Elbow Surg. 2002; 11: 624-629
        • O’Driscoll S.W.
        • Morrey B.F.
        Arthroscopy of the elbow. Diagnostic and therapeutic benefits and hazards.
        J Bone Joint Surg. 1992; 74: 84-94
        • Kelly E.M.
        • O’Driscoll S.W.
        Complications of elbow arthroscopy.
        J Bone Joint Surg. 2001; 83A: 25-34
        • Savoie 3rd, F.H.
        • Nunley P.D.
        • Field L.D.
        Arthroscopic management of the arthritic elbow.
        J Shoulder Elbow Surg. 1999; 8: 214-219
        • Menth-Chiari W.P.
        • Ruch D.S.
        Arthroscopic resection of the radial head.
        Arthroscopy. 1999; 15: 226-230
        • Lo I.K.
        Arthroscopic radial head excision.
        Arthroscopy. 1994; 10: 689-692
        • Husband J.H.
        The lateral approach for operative release of post-traumatic contracture of the elbow.
        J Bone Joint Surg. 1990; 72A: 1353-1358
        • Cohen M.H.
        Post-traumatic contracture of the elbow.
        J Bone Joint Surg. 1998; 80B: 805-812
        • Weiss A.S.
        Soft tissue contractures about the elbow.
        Hand Clin. 1994; 10: 439-451
        • Wilson P.
        Capsulectomy for the relief of flexion contractures of the elbow following a fracture.
        J Bone Joint Surg. 1944; 26: 71-86
        • Aldridge J.A.
        • Gunneson E.E.
        • Urbaniak J.R.
        Anterior release of the elbow for extension loss.
        J Bone Joint Surg. 2004; 86A: 1955-1960
        • Gates H.S.
        • Urbaniak J.R.
        Anterior capsulotomy and continuous passive motion in the treatment of post-traumatic flexion contracture of the elbow.
        J Bone Joint Surg. 1992; 74A: 1229-1234
        • Urbaniak J.H.
        • Beissinger S.F.
        • Aitken M.S.
        Correction of post-traumatic flexion contracture of the elbow by anterior capsulotomy.
        J Bone Joint Surg. 1985; 67A: 1160-1164
        • Bryan R.M.
        • Morrey B.F.
        Extensive posterior exposure of the elbow.
        Clin Orthop. 1982; 166: 188-192
        • Park M.K.
        Surgical treatment of post-traumatic stiffness of the elbow.
        J Bone Joint Surg. 2004; 86B: 1158-1162
        • Tsuge K.
        • et al.
        Arthroplasty of the elbow. Twenty years’ experience of a new approach.
        J Bone Joint Surg. 1987; 69: 116-120
        • Tsuge K.
        • Mizuseki T.
        Debridement arthroplasty for advanced primary osteoarthritis of the elbow. Results of a new technique used for 29 elbows.
        J Bone Joint Surg. 1994; 76: 641-646
        • Wada T.
        • Ishii S.
        • Yamashita T.
        Debridement arthroplasty for primary osteoarthritis of the elbow.
        J Bone Joint Surg. 2004; 86A: 233-241
        • Morrey B.F.
        Primary degenerative arthritis of the elbow.
        J Bone Joint Surg. 1992; 74B: 409-413
        • Froimson A.S.
        • Richey D.G.
        Cutis arthroplasty of the elbow joint.
        J Bone Joint Surg. 1976; 58A: 863-865
        • Knight R.V.Z.
        Arthroplasty of the elbow.
        J Bone Joint Surg. 1952; 34A: 610-618
        • Cheng S.M.
        • Morrey B.F.
        Treatment of the mobile, painful arthritic elbow by distraction interposition arthroplasty.
        J Bone Joint Surg. 2000; 82: 233-238
        • Mansat P.M.
        • Morrey B.F.
        Semiconstrained total elbow arthroplasty for ankylosed and stiff elbows.
        J Bone Joint Surg. 2000; 82A: 1260-1268
        • Hastings H.G.
        The classification and treatment of heterotopic ossification about the elbow and forearm.
        Hand Clin. 1994; 10: 417-437
        • Garland D.O.H.
        Fractures and dislocations about the elbow in the head-injured adult.
        Clin Orthop. 1982; 168: 38-41
        • Stein D.P.
        • Egol K.A.
        • Kaplan F.T.
        • Tejwani N.C.
        • Koval K.J.
        Prevention of heterotopic ossification at the elbow following trauma using radiation therapy.
        Bull Hosp Jt Dis. 2003; 61: 151-154
        • Garland D.O.
        Resection of heterotopic ossification in patients with spinal cord injuries.
        Clin Orthop. 1989; 242: 169-176
        • Ring D.J.
        • Jupiter J.B.
        Operative release of ankylosis of the elbow due to hetertopic ossification, surgical technique.
        J Bone Joint Surg. 2004; 86A: 2-10
        • McAuliffe J.W.
        Early excision of heterotopic ossification about the elbow followed by radiation therapy.
        J Bone Joint Surg. 1997; 79A: 749-755
        • Poggi M.T.
        • Johnstone P.A.
        Excision and radiotherapy for heterotopic ossification of the elbow.
        Orthopedics. 1999; 22: 1059-1061