Specialized Elbow Care in Colorado Springs

Post-traumatic Elbow Stiffness

Colorado Springs Orthopaedic Group

Your elbow connects the upper and lower arm and plays an important role in lifting, reaching, gripping, and other everyday movements. Elbow injuries and conditions can result from sports, repetitive use, trauma, arthritis, or problems affecting the tendons, nerves, and surrounding tissues.

At CSOG, our specialists provide comprehensive care for a wide range of elbow conditions, including tendon injuries, nerve compression, instability, arthritis, fractures, and sports-related injuries. Treatment is based on your diagnosis and may range from conservative care and physical therapy to injections, minimally invasive procedures, and surgery.

Our goal is to identify the source of your elbow problem and provide an individualized treatment approach that helps relieve pain, restore movement and strength, and return you to your normal activities.

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What is Post-traumatic Stiffness?

Medically, stiffness is difficulty moving a joint due to the loss of the joint’s range of motion caused by an injury (trauma) or a disorder.

Post-traumatic stiffness is a disabling complication caused by trauma resulting in reduced or loss of motion and functional impairment.

Post-traumatic stiffness in your elbow will make it difficult for you to bend or straighten the elbow and perform daily activities. Post-traumatic stiffness can be extrinsic or intrinsic.

What are the Causes of Post-traumatic Stiffness?

The major causes of post-traumatic stiffness in the elbow can be:

• Bone fracture in the elbow
• Previous surgery to the joint
• Loose bodies in the elbow
• Mal-union (improper healing of a fractured bone)
• Bone dislocations in the joint
• Heterotopic ossification (bone growth in non-skeletal tissues)
• Cranial trauma (injury to brain, skull, or scalp)

The cause of post-traumatic elbow stiffness is the basis for its diagnosis and treatment.

What are the Symptoms of Post-traumatic Stiffness?

Following are the apparent and main symptoms of post-traumatic stiffness in the elbow:

• Pain in the elbow
• A feeling of a locked elbow
• Decreased motion of the joint

How is Post-traumatic Stiffness Diagnosed?

Evaluation of your medical history coupled with a physical examination of the affected elbow is the first step in the diagnosis of post-traumatic stiffness. Subsequently, the doctor will look for the flexion range and inflammation. An X-ray (radiograph), a CT scan or an MRI may also be ordered to confirm the initial diagnosis.

What are the Treatment Options for Post-traumatic Stiffness?

Nonoperative Options

Splinting (static or dynamic) of the elbow will be the first line of nonoperative treatment. Other options can be:

• Physical therapy or physical therapy
• Occupational therapy
• Serial casting of the joint
• Movement exercises
• Passive mobilization
• Joint immobilization
• Manipulation under anesthesia
• Administration of NSAID
• Botulinum toxin A injections

Operative Options

If nonoperative options do not produce results, your doctor may consider surgical procedures such as:

• Open arthrolysis (with external fixation)
• Arthroscopic arthrolysis
• Partial or total elbow arthroplasty
• Interposition arthroplasty
• Corrective osteotomy with arthrolysis
• Capsular release
• Osteophyte excision
• Musculocutaneous neurectomy

These procedures, however, may carry a few post-operative risks like damage to nerves or blood vessels and returning stiffness.

What Happens After Your Surgery?

Soon after the surgery, your elbow will be splinted in extension for 24 hours. The objective is to rest the tissues and minimize bleeding and/or swelling. Once the splint is removed, a compression dressing will be applied. Ice or a compression ice system may be used for 20 minutes every one to two hours during the first 72 hours.

What Does Rehabilitation After Surgery Involve?

Postoperative rehabilitation plays an important role in the outcome of your surgery and every patient needs an individualized approach for the best result.

Rehabilitation begins with a continuous passive motion for flexion-extension, 72 hours after the surgery. After six weeks, you may be asked to start static progressive splinting to increase motion. Splinting, therapies and exercises may be required to maintain until a plateau is reached.