Elbow - the middle joint of our upper limb, is that joint of our body which lies between shoulder and wrist joints. Its main role is in the spacial orientation of the hand, both towards and away from the objects .
The commonest fracture of paediatric age group occurs around elbow, and mismanagement of this injury is a major cause of deformity and stiffness due to massage leading to formation of bone in the muscles, a condition known as heterotrophic ossification. It has been observed that in adults the chances of developing heterotrophic ossification in simple elbow dislocation is around 3%, but increase to 20% if dislocation also involves a fracture of the joint, moreover its important to note that if any person has head injury along with injured elbow his chances of developing heterotrophic ossification are increased to 75 to 90%
Although it is not the commonest joint to get injured in the adults, but its a joint where post traumatic stiffness is very common. Not only this, the management of this stiffness is even more time consuming and difficult and in some cases the stiffness may persist for life.
The first and foremost requirement to prevent this stiffness is the appropriate management of any type bony or soft tissue injury around the joint. Any insult to the joint can cause stiffness if adequate measures are not taken to prevent it. But what if the stiffness is already set in?
As soon as you recognize that your elbow movements are restricted, you should consult an expert, the treatment of elbow stiffness is dependent on the type, severity, duration and age of the patient.
On the basis of how much movement you have the stiffness is categorised as mild moderate and severe, In mild to moderate types with duration of insult of less than 6 weeks physiotherapy is tried with splinting, but with more duration and in severe cases surgery is only alternative left to gain if not full movement, at least functional range which in studies have been found to be between 30 degree to extension to 130 degree of flexion ( the normal range being 0 degree to 150 degree).
The surgery of stiff elbow is not without complications, and poor results can come if adequate follow up and physiotherapy post surgery is neglected. So the decision to operate on stiff elbow is taken with a judicious consultation between the patient, the therapist and the doctor.
The commonest fracture of paediatric age group occurs around elbow, and mismanagement of this injury is a major cause of deformity and stiffness due to massage leading to formation of bone in the muscles, a condition known as heterotrophic ossification. It has been observed that in adults the chances of developing heterotrophic ossification in simple elbow dislocation is around 3%, but increase to 20% if dislocation also involves a fracture of the joint, moreover its important to note that if any person has head injury along with injured elbow his chances of developing heterotrophic ossification are increased to 75 to 90%
Although it is not the commonest joint to get injured in the adults, but its a joint where post traumatic stiffness is very common. Not only this, the management of this stiffness is even more time consuming and difficult and in some cases the stiffness may persist for life.
The first and foremost requirement to prevent this stiffness is the appropriate management of any type bony or soft tissue injury around the joint. Any insult to the joint can cause stiffness if adequate measures are not taken to prevent it. But what if the stiffness is already set in?
As soon as you recognize that your elbow movements are restricted, you should consult an expert, the treatment of elbow stiffness is dependent on the type, severity, duration and age of the patient.
On the basis of how much movement you have the stiffness is categorised as mild moderate and severe, In mild to moderate types with duration of insult of less than 6 weeks physiotherapy is tried with splinting, but with more duration and in severe cases surgery is only alternative left to gain if not full movement, at least functional range which in studies have been found to be between 30 degree to extension to 130 degree of flexion ( the normal range being 0 degree to 150 degree).
The surgery of stiff elbow is not without complications, and poor results can come if adequate follow up and physiotherapy post surgery is neglected. So the decision to operate on stiff elbow is taken with a judicious consultation between the patient, the therapist and the doctor.
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