Abstract
The purpose of this study is to evaluate the outcomes of the treatment of stiff elbow with the use of dynamic orthoses. We included 30 patients with stiff elbow with an arc of mobility of 100° or less and a stable and congruent joint without heterotopic ossifications. The dynamic orthosis was designed in our service and consists of an articulated brace with springs. Mean previous mobility was 109°–41°, with an average arc of motion of 68°. Its use began 78 days after surgery or trauma and continued for 75 days. Statistical analysis was performed. Average follow-up was 23 months. Postoperative mobility was 126°–21° with an improvement of 37° of mobility. Ten patients did not recover a functional range of motion. Twenty-three patients were satisfied with the treatment and seven were unsatisfied with the use of the orthosis. Our results suggest that dynamic orthoses are useful in the treatment of stiff elbow. We achieved a mean improvement of 37° in the arc of motion, which in many cases has rendered arthrolysis unnecessary. The major strength of this paper is the practical application of the orthosis and its relatively easy manufacture.
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Hildebrand KA, Zhang M, Hart DA (2005) High rate of joint capsule matrix turnover in chronic human elbow contractures. Clin Orthop Relat Res 439:228–234
Hildebrand KA, Zhang M, Van Snellenberg W, King GJ, Hart DA (2004) Myofibroblast numbers are elevated in human elbow capsules after trauma. Clin Orthop Relat Res 419:189–197
Morrey BF (1990) Post-traumatic stiffness: distraction arthroplasty. Orthopaedics 15:863–869
Jupiter JB, O’Driscoll SW, Cohen MS (2003) The assessment and management of the stiff elbow. Instr Course Lect 52:93–111
Bruno RJ, Lee ML, Strauch RJ, Rosenwasser MP (2002) Posttraumatic elbow stiffness: evaluation and management. J Am Acad Orthop Surg 10:106–116
Mansat P, Morrey BF (1998) The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am 80:1603–1615
Wada T, Ishii S, Usui M, Miyano S (2000) The medial approach for operative release of posttraumatic contracture of the elbow. J Bone Joint Surg Br 82:68–73
Ball CM, Meunier M, Galatz LM, Calfee R, Yamaguchi K (2002) Arthroscopic treatment of post-traumatic elbow contracture. J Shoulder Elbow Surg 11:624–629
Bonutti M, Windau JE, Ables BA, Miller BG (1994) Static progressive stretch to reestablish elbow range of motion. Clin Orthop Relat Res 303:128–134
Duke JB, Tessler RH, Dell PC (1991) Manipulation of the stiff elbow with patient under anesthesia. J Hand Surg Am 16:19–24
Zander CL, Healy NL (1992) Elbow flexion contractures treated with serial casts and conservative therapy. J Hand Surg Am 17:694–697
Doornberg MS, Ring D, Jupiter JB (2006) Static progressive splinting for posttraumatic elbow stiffness. J Orthop Trauma 20:400–404
Gelinas JJ, Faber KJ, Patterson SD, King GJ (2000) The effectiveness of turnbuckle splinting for elbow contractures. J Bone Joint Surg Br 82:74–78
Green DP, McCoy H (1979) Turnbuckle orthotic correction of elbow flexion contractures after acute injuries. J Bone Joint Surg Am 61:1092–1095
Schultz-Johnson K (2002) Static progressive splinting. J Hand Therapy 15:163–178
Muller AM et al (2013) Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies. J Shoulder Elbow Surg 22:1146–1152
Einhorn TA, O’Keefe RJ, Buckwalter JA (2006) Orthopaedic basic science: foundations of clinical practice, 3rd edn. American Academy of Orthopaedic Surgeons, Rosemont
Lindenhovius AL, Doornberg JN, Brouwer KM, Jupiter JB, Mudgal CS, Ring D (2012) A prospective randomized controlled trial of dynamic versus static progressive elbow splinting for posttraumatic elbow stiffness. J Bone Joint Surg Am 94:694–700
Szekeres M (2006) A biomechanical analysis of static progressive elbow flexion splinting. J Hand Therapy 19:34–3818
Gallucci GL, Boretto JG, Davalos MA, Donndorff A, Alfie VA, De Carli P (2011) Dynamic splint for the treatment of stiff elbow. Shoulder Elbow 3:52–55
Charalambous CP, Morrey BF (2012) Posttraumatic elbow stiffness. J Bone Joint Surg Am 94:1428–1437
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Gallucci, G.L., Boretto, J.G., Dávalos, M.A. et al. The use of dynamic orthoses in the treatment of the stiff elbow. Eur J Orthop Surg Traumatol 24, 1395–1400 (2014). https://doi.org/10.1007/s00590-014-1419-y
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DOI: https://doi.org/10.1007/s00590-014-1419-y