Elbow Trauma and Arthrofibrosis

Abstract

Elbow range-of-motion loss is a common complication of elbow trauma. A number of pathologies can cause range-of-motion loss including a mechanical block from a displaced fracture fragment, arthrofibrosis, capsular contraction, or elbow instability. Magnetic resonance imaging (MRI) can assist the physician to identify some of the pathology responsible for the stiff elbow. Osteochondral fragments that may not be recognized on plain radiographs can often be seen with MRI. MRI can help characterize osteophyte size and location as well as loose bodies. MRI is also useful for evaluating the ligamentous structures about the elbow, helping in the diagnosis of elbow instability. Arthroscopy is a useful tool in the treatment of the stiff elbow, and its indications continue to expand. It provides minimally invasive access to the elbow joint and allows for loose-body removal, osteophyte debridement, fracture reduction and fixation, and arthrofibrosis takedown. This chapter will use two patient cases to correlate MRI findings with those found at the time of elbow arthroscopy.