The Stiff Elbow: Classification and Treatment Algorithm

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.