Elbow Contracture

Elbow contracture refers to a stiff elbow with limited range of motion. It is a common complication following elbow surgery, fractures, dislocations, and burns.

The normal functional range of motion for an elbow is 30-145 degrees. A stiff or contracted elbow may be diagnosed when the ability to extend or flex the arm is lessened by 30 degrees or more. Flexion contractures greater than 45 degrees will significantly affect the patient’s ability to perform activities of daily living such as bathing and eating.

Symptoms

Symptoms of Elbow Contracture include the following:

  • Stiffness of the elbow
  • Inability to fully extend or flex the arm
  • Usually no pain is associated with elbow contractures.

Causes

Causes and risk factors associated with elbow contracture, include:

  • Elbow trauma
  • Elbow surgery
  • Osteoarthritis
  • Rheumatoid arthritis
  • Loose bodies
  • Osteophytes or bone spurs
  • Malunions of fractures
  • Joint infection
  • Burns

Diagnosis

Elbow conditions should be evaluated by an Orthopedic surgeon for proper diagnosis and treatment. Your surgeon will review your medical history, and perform a physical examination and order diagnostic studies such as X-ray, CT scan, MRI, and nerve conduction studies.

Treatment

Conservative Treatment:

Conservative treatment options for elbow contracture can successfully treat most elbow

contractures of less than 6 months duration. These options will be based on your particular situation and may include the following:

  • Physical Therapy
  • Splinting
  • Casting
  • Manipulation

Surgical treatment

If conservative treatment options fail to improve the elbow contracture despite the patient’s adherence to physical therapy, surgery may be recommended.

Capsular Release is a surgical procedure to release the contracture associated with elbow stiffness. This surgery may be performed through a large, open incision or arthroscopically through much smaller incisions. Arthroscopic Elbow Capsular Release is a minimally invasive surgery performed in a hospital operating room under general or regional anesthesia.

Your surgeon will discuss the options with you and decide which surgical technique will be used based on your situation.

Post-Operative Care

After surgery, your surgeon will give you instructions to follow depending on the type of repair performed and the surgeon’s preference.

Common post-operative care following elbow contracture release includes the following:

  • Initially, you will have a lightly wrapped, bulky bandage from your shoulder to your hand to minimize swelling and bleeding.
  • A catheter will be placed and left in the axillary or armpit area for administering a brachial plexus block anesthetic for pain relief.
  • Continuous passive range of motion will begin within a day after surgery.
  • Elevating the elbow on a pillow and applying ice packs over the dressing will help reduce swelling.
  • Keep the incisions clean and dry. You may shower once the dressings are removed unless otherwise directed by your surgeon.
  • You will be given specific instructions regarding activity and rehabilitation. It is imperative that you comply with physical therapy directions for the best outcome from your surgery.
  • Eating a healthy diet and quitting smoking will promote healing.

Risks and Complications

Arthroscopic Elbow Capsular Release is a safe procedure that rarely involves any major complications. Some possible complications may include infection and nerve damage.

  • American Academy of Orthopaedic Surgeons
  • American Society for Surgery of the Hand
  • St. Luke's Roosevelt
  • Texas Scottish Rite Hospital for Children
  • NYU School of Medicine
  • North Shore LIJ
  • Pro Medical Newyork