The assessment and management of the stiff elbow

Posttraumatic loss of elbow motion can cause substantial disability, limiting the ability to put one's hand in the volume of a sphere in space. Although a number of conditions can lead to loss of motion, a greater understanding of the functional anatomy of the elbow has led to advances in surgical management. Elbow stiffness has been classified in a number of ways, but the consistent feature is capsular contracture. Treatment of the stiff elbow begins with clinical evaluation of elbow stiffness and identification of indications for surgical intervention. Techniques of open and arthroscopic elbow contracture release are evolving. Assessment and management of elbow contracture associated with heterotopic ossification, and treatment of distal humerus nonunion should be done early to restore elbow motion.