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The Stiff Elbow: Classification and Treatment Algorithm

  • Enrico Guerra
  • Francois M. Kelberine
  • Alessandro MarinelliEmail author
  • Roberto Rotini
  • Gregory Bain
Chapter

Abstract

Elbow stiffness is poorly tolerated because of the lack of compensatory motions in adjacent joints. The elbow joint is prone to stiffness following a multitude of causes. Being able to classify elbow stiffness can help in planning treatment. The cause of joint stiffness can be classified with the ISAKOS patho-anatomical classification of joint stiffness, which takes into account the articular, capsular, extra-articular, and neurologic causes of joint stiffness. This classification, identifying the pathological process present in each area, allows the surgeon to address each component and tailor the appropriate treatment. Another recently proposed classification, called STIF classification, recognizing five common disorders causing stiffness and six influencing factors, allows to define a practical treatment algorithm, to guide surgical treatment and the preferred operative approach, open or scope.

Keywords

Elbow stiffness Elbow contracture Joint stiffness Classification Algorithm Surgical release Elbow arthroplasty 

References

  1. 1.
    Bain GI, Clitherow HDS. The pathogenesis and classification of shoulder stiffness. In: Itoi E, et al., editors. Shoulder stiffness: current concepts and concerns: ISAKOS; 2015.Google Scholar
  2. 2.
    Morrey BF. The posttraumatic stiff elbow. Clin Orthop Relat Res. 2005;431:26–35.Google Scholar
  3. 3.
    Watts AC, Bain GI. New techniques in elbow arthroscopy. In: Savoie FH, Field LD, editors. AANA advanced arthroscopy: the elbow and wrist. Philadelphia: Saunders-Elsevier; 2010. p. 124–31.Google Scholar
  4. 4.
    Kay NR. Arthrolysis of the post-traumatic stiff elbow. In: Stanley D, Kay NR, editors. Surgery of the elbow. London: Arnold; 1998. p. 228–34.Google Scholar
  5. 5.
    Marinelli A, Rotini R, Guerra E, O’Driscoll S. The S.T.I.F classification: a new classification for elbow stiffness, considering Stiffness Types and Influencing Factors. Presented at the Rizzoli Elbow Course, Bologna, Italy; 2017.Google Scholar
  6. 6.
    Marinelli A, Bain GI. The stiff elbow: classification and treatment algorithm. ISAKOS Newsletter. 2018;2:18–21.Google Scholar
  7. 7.
    Jupiter JB, O’Driscoll SW, Cohen MS. The assessment and management of the stiff elbow. Instr Course Lect. 2003;52:93–111.PubMedGoogle Scholar

Copyright information

© ISAKOS 2020

Authors and Affiliations

  • Enrico Guerra
    • 1
  • Francois M. Kelberine
    • 2
  • Alessandro Marinelli
    • 1
    Email author
  • Roberto Rotini
    • 1
  • Gregory Bain
    • 3
  1. 1.Shoulder and Elbow Surgery UnitIstituto Ortopedico RizzoliBolognaItaly
  2. 2.Pôle Aixois de Chirurgie Articulaire et Sportive, Clinique PPRPAix-en-ProvenceFrance
  3. 3.Upper Limb and Research, Department of Orthopedic and Trauma SurgeryFlinders UniversityAdelaideAustralia

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