What is Elbow Contracture?
Elbow contracture refers to a stiff elbow with a limited range of motion. It is a common complication following elbow surgery, fractures, dislocations, and burns.
The normal range of motion for an elbow is 0 -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 your ability to perform activities of daily living such as bathing and eating. Loss of extension of more than 30 degrees is more cosmetic rather than functional but will affect your reach.
Symptoms of Elbow Contracture
The symptoms of elbow contracture include the following:
- Stiffness of the elbow
- Inability to fully extend or flex the arm
- Usually, no associated pain but can be especially if associated with some underlying arthritis
Causes of Elbow Contracture
The 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 of Elbow Contracture
Your surgeon will review your medical history and perform a physical examination. Various diagnostic studies may be ordered such as X-ray, CT scan, MRI and/or nerve conduction studies.
Treatment options for Elbow Contracture
Conservative Treatment for Elbow Contracture
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 condition and may include the following:
- Physical therapy
- Splinting
- Casting
- Manipulation
Surgical Treatment for Elbow Contracture
If conservative treatment options fail to improve the elbow contracture despite your 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 anaesthesia.
Your surgeon will discuss the options with you and decide which surgical technique will be best for your condition.
Postoperative Care after Elbow Capsular Release
After surgery, your surgeon will give you instructions to follow depending on the type of surgery performed. Common postoperative 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 splint for the first post-operative night is often used to stretch the muscles at the front of the elbow.
- Elevate the elbow on a pillow and applying ice packs over the dressing to 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.