Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 5, pp 613–617

Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients

  • Ewout S. Veltman
  • Job N. Doornberg
  • Denise Eygendaal
  • Michel P. J. van den Bekerom
Orthopaedic Surgery

DOI: 10.1007/s00402-015-2199-5

Cite this article as:
Veltman, E.S., Doornberg, J.N., Eygendaal, D. et al. Arch Orthop Trauma Surg (2015) 135: 613. doi:10.1007/s00402-015-2199-5

Abstract

Introduction

The elbow is prone to stiffness after trauma. To regain functional elbow motion, several conservative and surgical treatment options are available. Nonoperative treatment includes physical therapy, intra-articular injections with corticosteroids, and a static progressive or dynamic splinting program. The objective of this study was to perform a comprehensive review of the literature to evaluate the best current evidence for nonoperative treatment options for posttraumatic elbow stiffness.

Methods

We performed a search of all studies on nonoperative treatment for elbow stiffness in human adults. All articles describing nonoperative treatment of elbow stiffness, written in the English, German, French or Dutch language, including human adult patients and with the functional outcome reported were included in this study.

Results

Eight studies (including 232 patients) met our eligibility criteria and were included for data analysis and pooling. These studies included one randomized controlled trial and seven retrospective cohort studies. Static progressive splinting was evaluated in 160 patients. The average pre-splinting range of motion of all elbows was 72°, which improved by 36° after splinting to an average post-splinting arc of motion of 108°. Dynamic splinting was evaluated in 72 patients with an average pre-splinting range of motion of 63°. The average improvement was 37° to an average post-splinting arc of motion of 100°.

Conclusions

Both dynamic orthoses and static progressive splinting show good results for the treatment of elbow stiffness, regardless of etiology. The choice for one treatment over the other is based on the preference of the surgeon and patient. We recommend to continue nonoperative treatment with dynamic or static bracing for 12 months or until patients stop making progression in range of elbow motion.

Keywords

Elbow stiffness Conservative treatment Static splint Dynamic splint 

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Ewout S. Veltman
    • 1
  • Job N. Doornberg
    • 2
  • Denise Eygendaal
    • 3
  • Michel P. J. van den Bekerom
    • 4
  1. 1.Department of Orthopaedic SurgerySpaarne hospitalHoofddorpThe Netherlands
  2. 2.University of Amsterdam Orthopaedic Residency Program, Orthotrauma Research CenterAcademic Medical CenterAmsterdamThe Netherlands
  3. 3.Department of Orthopaedic SurgeryAmphia hospitalBredaThe Netherlands
  4. 4.Department of Orthopaedic Surgery, Shoulder and Elbow UnitOLVGAmsterdamThe Netherlands