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J Orthop Trauma. 2006 Jul;20(6):400-4.

Static progressive splinting for posttraumatic elbow stiffness.

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1
University of Amsterdam, Orthotrauma Research Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.

Abstract

OBJECTIVES:

To determine the value of static progressive splinting in helping patients with posttraumatic elbow stiffness regain functional motion and avoid operative treatment for stiffness.

DESIGN:

Retrospective case series.

SETTING:

Level I Trauma Center.

PATIENTS AND INTERVENTION:

Over a 3-year period, 29 consecutive patients with elbow stiffness after trauma (flexion contracture greater than 30 degrees or flexion less than 130 degrees) were treated with static progressive elbow splinting when a standard exercise program was no longer achieving gains in motion. Three patients were treated after the injury alone; 14 were treated after operative treatment of the initial injury, and 12 after a secondary operative contracture release for posttraumatic stiffness. Splinting was initiated on an average of 55 days (range, 15 to 200 d) after injury or operative treatment.

MAIN OUTCOME MEASUREMENTS:

Ulnohumeral range of motion before and after splint treatment.

RESULTS:

The flexion arc improved from 71 degrees (range, 0 to 100 degrees) before splinting to 112 degrees (range, 20 to 150 degrees) after splinting. After splinting, 3 patients had a flexion contracture greater than 30 degrees and 10 patients (34%) had fewer than 130 degrees of flexion. Only 3 patients-2 with heterotopic bone and 1 with an associated ulnar neuropathy-requested an operation to address elbow stiffness. Patients who were splinted after the initial injury (n=17, average improvement (fl-ext)=51+/-37 degrees) regained greater motion during splint wear than patients treated after elbow capsulectomy (n=12, average improvement (fl-ext)=22+/-24 degrees).

CONCLUSIONS:

Static progressive splinting can help gain additional motion when standard exercises seem stagnant or inadequate, particularly after the original injury. Operative treatment of stiffness was avoided in most patients.

PMID:
16825965
[Indexed for MEDLINE]
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