[Classification of elbow stiffness and indications for surgical treatment]

An elbow can become stiff for a variety of reasons, such as intra-articular or extra-articular fractures, soft-tissue trauma, prolonged immobilization, thermal injury, infection, inflammatory arthritis, osteoarthrosis and heterotopic bone formation. Elbow stiffness is usually classified into extrinsic (affecting the capsule and extra-articular soft tissues), intrinsic (affecting the synovial and intra-articular structures) and mixed forms. Indications for operative treatment have to be considered in cases of failed conservative treatment with severe functional deficits. The choice of operative treatment has to be based on a thorough analysis of the underlying cause, the affected structures, the pathogenesis and the individual needs. Options are an arthroscopic or open arthrolysis, endoprostheses, hinged external fixators, interposition arthroplasty or combinations of these procedures.