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J Am Acad Orthop Surg, Vol 10, No 2, March/April 2002, 106-116.
© 2002 the American Academy of Orthopaedic Surgeons
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Posttraumatic Elbow Stiffness: Evaluation and Management

Roderick J. Bruno, MD, Michael L. Lee, MD, Robert J. Strauch, MD and Melvin P. Rosenwasser, MD

Dr. Bruno is Clinical Instructor, Department of Orthopaedics, Tufts University School of Medicine, New England Medical Center, Boston, MA. Dr. Lee is an Associate, University Sports Medicine, Corpus Christi, TX. Dr. Strauch is Assistant Professor, Department of Orthopaedic Surgery, Columbia University, New York, NY. Dr. Rosenwasser is Robert E. Carroll Professor of Hand Surgery, Department of Orthopaedic Surgery, Columbia University.

Reprint requests: Dr. Rosenwasser, Columbia University, 622 West 168th Street, PH-11, New York NY 10032.

Posttraumatic elbow stiffness is a common problem that is often difficult to manage. The goal of treatment is to restore a functional range of elbow motion (≥30° to 130°). Nonsurgical treatment includes physical therapy and splinting. If nonsurgical treatment has failed, the type of surgical treatment required depends on the extent of degenerative changes. When degenerative changes are absent or mild, soft-tissue release offers reliable increases in elbow motion. When moderate degenerative changes exist within the joint, débridement arthroplasty of osteophytes and soft tissue has shown some success with increase in joint motion. With advanced degenerative changes, the therapeutic options are more limited. Results from biologic resurfacing arthroplasty are unpredictable, and total elbow arthroplasty should be reserved for the lower-demand elbow in a physiologically older individual.




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