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Management of a Post-traumatic Stiff Elbow: A Case Report
Parin Shah1, Priti Ranjan Sinha1, Shubham Jain1
1Department of Orthopedics, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
Introduction:
Elbow movement is crucial for proper upper limb function, allowing the hand to be positioned accurately in space. However, the elbow is highly susceptible to stiffness, which can result from a variety of traumatic or non-traumatic causes. Diagnosis of elbow stiffness involves a thorough medical history and physical examination, often supported by relevant imaging studies. Managing a stiff elbow can be difficult, making prevention a key consideration. If preventive measures are insufficient, treatment typically progresses from non-surgical to surgical options. For patients presenting with mild contractures of 6 months or less, non-operative approaches such as static or dynamic splinting, serial casting, continuous passive motion, physical or occupational therapy, and joint manipulation may be utilized. When these conservative methods fail, surgical intervention, either arthroscopic or open, can be performed to remove soft tissue or bony obstacles that limit motion.
Case Report:
A case report of a 15-year-old girl who developed elbow stiffness following a fall and subsequent undiagnosed fracture is presented. Despite conservative management, she experienced no significant improvement, prompting surgical intervention. The patient underwent a lateral approach to remove Heterotropic ossification and loose bodies, resulting in marked improvement in range of motion (ROM) and patient satisfaction post-operatively.
Conclusion:
Post-traumatic elbow stiffness, frequently associated with heterotopic ossification, can be difficult to treat. Prompt recognition and timely intervention, whether through conservative measures or surgery, are key to achieving optimal results. In cases of severe contracture, surgical techniques such as the lateral column procedure have proven effective in restoring both ROM and overall elbow function.
