Elbow Contracture
Elbow contracture refers to a stiff elbow with limited range of motion. It is a common complication following elbow surgery, fractures, dislocations, and burns.
The normal functional range of motion for an elbow is 30-145 degrees. A stiff or contracted elbow may be diagnosed when the ability to extend or flex the arm is lessened by 30 degrees or more. Flexion contractures greater than 45 degrees will significantly affect the patient’s ability to perform activities of daily living such as bathing and eating.
Symptoms.
Symptoms of Elbow Contracture include the following:
Stiffness of the elbow
Inability to fully extend or flex the arm
Usually no pain is associated with elbow contractures.
Causes.
Causes and risk factors associated with elbow contracture, include:
Elbow trauma
Elbow surgery
Osteoarthritis
Rheumatoid arthritis
Loose bodies
Osteophytes or bone spurs
Malunions of fractures
Joint infection
Burns
Diagnosis.
Elbow conditions should be evaluated by an Orthopedic surgeon for proper diagnosis and treatment. Your surgeon will review your medical history, and perform a physical examination and order diagnostic studies such as X-ray, CT scan, MRI, and nerve conduction studies.
Treatment.
Conservative Treatment:
Conservative treatment options for elbow contracture can successfully treat most elbow contractures of less than 6 months duration. These options will be based on your particular situation and may include the following:
Physical Therapy
Splinting
Casting
Manipulation
Surgical treatment.
If conservative treatment options fail to improve the elbow contracture despite the patient’s adherence to physical therapy, surgery may be recommended.
Capsular Release is a surgical procedure to release the contracture associated with elbow stiffness. This surgery may be performed through a large, open incision or arthroscopically through much smaller incisions. Arthroscopic Elbow Capsular Release is a minimally invasive surgery performed in a hospital operating room under general or regional anesthesia.
Your surgeon will discuss the options with you and decide which surgical technique will be used based on your situation.
Post-Operative Care.
After surgery, your surgeon will give you instructions to follow depending on the type of repair performed and the surgeon’s preference.
Common post-operative care following elbow contracture release includes the following:
Initially, you will have a lightly wrapped, bulky bandage from your shoulder to your hand to minimize swelling and bleeding.
A catheter will be placed and left in the axillary or armpit area for administering a brachial plexus block anesthetic for pain relief.
Continuous passive range of motion will begin within a day after surgery.
Elevating the elbow on a pillow and applying ice packs over the dressing will help reduce swelling.
Keep the incisions clean and dry. You may shower once the dressings are removed unless otherwise directed by your surgeon.
You will be given specific instructions regarding activity and rehabilitation. It is imperative that you comply with physical therapy directions for the best outcome from your surgery.
Eating a healthy diet and quitting smoking will promote healing.
Risks and Complications.
Arthroscopic Elbow Capsular Release is a safe procedure that rarely involves any major complications. Some possible complications may include infection and nerve damage.
Elbow contracture is condition of elbow stiffness characterized by limited range of motion that can occur from elbow surgery, fractures, dislocations, and burns. Elbow contracture may hamper the individual in performing daily routine activities but can be treated successfully either by employing conservative interventions or surgery if required.
