Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 8/2014

01.12.2014 | Original Article

The use of dynamic orthoses in the treatment of the stiff elbow

verfasst von: Gerardo L. Gallucci, Jorge G. Boretto, María A. Dávalos, Verónica A. Alfie, Agustín Donndorff, Pablo De Carli

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

The purpose of this study is to evaluate the outcomes of the treatment of stiff elbow with the use of dynamic orthoses. We included 30 patients with stiff elbow with an arc of mobility of 100° or less and a stable and congruent joint without heterotopic ossifications. The dynamic orthosis was designed in our service and consists of an articulated brace with springs. Mean previous mobility was 109°–41°, with an average arc of motion of 68°. Its use began 78 days after surgery or trauma and continued for 75 days. Statistical analysis was performed. Average follow-up was 23 months. Postoperative mobility was 126°–21° with an improvement of 37° of mobility. Ten patients did not recover a functional range of motion. Twenty-three patients were satisfied with the treatment and seven were unsatisfied with the use of the orthosis. Our results suggest that dynamic orthoses are useful in the treatment of stiff elbow. We achieved a mean improvement of 37° in the arc of motion, which in many cases has rendered arthrolysis unnecessary. The major strength of this paper is the practical application of the orthosis and its relatively easy manufacture.
Literatur
1.
Zurück zum Zitat Hildebrand KA, Zhang M, Hart DA (2005) High rate of joint capsule matrix turnover in chronic human elbow contractures. Clin Orthop Relat Res 439:228–234PubMedCentralPubMedCrossRef Hildebrand KA, Zhang M, Hart DA (2005) High rate of joint capsule matrix turnover in chronic human elbow contractures. Clin Orthop Relat Res 439:228–234PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Hildebrand KA, Zhang M, Van Snellenberg W, King GJ, Hart DA (2004) Myofibroblast numbers are elevated in human elbow capsules after trauma. Clin Orthop Relat Res 419:189–197PubMedCrossRef Hildebrand KA, Zhang M, Van Snellenberg W, King GJ, Hart DA (2004) Myofibroblast numbers are elevated in human elbow capsules after trauma. Clin Orthop Relat Res 419:189–197PubMedCrossRef
3.
Zurück zum Zitat Morrey BF (1990) Post-traumatic stiffness: distraction arthroplasty. Orthopaedics 15:863–869 Morrey BF (1990) Post-traumatic stiffness: distraction arthroplasty. Orthopaedics 15:863–869
4.
Zurück zum Zitat Jupiter JB, O’Driscoll SW, Cohen MS (2003) The assessment and management of the stiff elbow. Instr Course Lect 52:93–111PubMed Jupiter JB, O’Driscoll SW, Cohen MS (2003) The assessment and management of the stiff elbow. Instr Course Lect 52:93–111PubMed
5.
Zurück zum Zitat Bruno RJ, Lee ML, Strauch RJ, Rosenwasser MP (2002) Posttraumatic elbow stiffness: evaluation and management. J Am Acad Orthop Surg 10:106–116PubMed Bruno RJ, Lee ML, Strauch RJ, Rosenwasser MP (2002) Posttraumatic elbow stiffness: evaluation and management. J Am Acad Orthop Surg 10:106–116PubMed
6.
Zurück zum Zitat Mansat P, Morrey BF (1998) The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am 80:1603–1615PubMed Mansat P, Morrey BF (1998) The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am 80:1603–1615PubMed
7.
Zurück zum Zitat Wada T, Ishii S, Usui M, Miyano S (2000) The medial approach for operative release of posttraumatic contracture of the elbow. J Bone Joint Surg Br 82:68–73PubMedCrossRef Wada T, Ishii S, Usui M, Miyano S (2000) The medial approach for operative release of posttraumatic contracture of the elbow. J Bone Joint Surg Br 82:68–73PubMedCrossRef
8.
Zurück zum Zitat Ball CM, Meunier M, Galatz LM, Calfee R, Yamaguchi K (2002) Arthroscopic treatment of post-traumatic elbow contracture. J Shoulder Elbow Surg 11:624–629PubMedCrossRef Ball CM, Meunier M, Galatz LM, Calfee R, Yamaguchi K (2002) Arthroscopic treatment of post-traumatic elbow contracture. J Shoulder Elbow Surg 11:624–629PubMedCrossRef
9.
Zurück zum Zitat Bonutti M, Windau JE, Ables BA, Miller BG (1994) Static progressive stretch to reestablish elbow range of motion. Clin Orthop Relat Res 303:128–134PubMed Bonutti M, Windau JE, Ables BA, Miller BG (1994) Static progressive stretch to reestablish elbow range of motion. Clin Orthop Relat Res 303:128–134PubMed
10.
Zurück zum Zitat Duke JB, Tessler RH, Dell PC (1991) Manipulation of the stiff elbow with patient under anesthesia. J Hand Surg Am 16:19–24PubMedCrossRef Duke JB, Tessler RH, Dell PC (1991) Manipulation of the stiff elbow with patient under anesthesia. J Hand Surg Am 16:19–24PubMedCrossRef
11.
Zurück zum Zitat Zander CL, Healy NL (1992) Elbow flexion contractures treated with serial casts and conservative therapy. J Hand Surg Am 17:694–697PubMedCrossRef Zander CL, Healy NL (1992) Elbow flexion contractures treated with serial casts and conservative therapy. J Hand Surg Am 17:694–697PubMedCrossRef
12.
Zurück zum Zitat Doornberg MS, Ring D, Jupiter JB (2006) Static progressive splinting for posttraumatic elbow stiffness. J Orthop Trauma 20:400–404PubMedCrossRef Doornberg MS, Ring D, Jupiter JB (2006) Static progressive splinting for posttraumatic elbow stiffness. J Orthop Trauma 20:400–404PubMedCrossRef
13.
Zurück zum Zitat Gelinas JJ, Faber KJ, Patterson SD, King GJ (2000) The effectiveness of turnbuckle splinting for elbow contractures. J Bone Joint Surg Br 82:74–78PubMedCrossRef Gelinas JJ, Faber KJ, Patterson SD, King GJ (2000) The effectiveness of turnbuckle splinting for elbow contractures. J Bone Joint Surg Br 82:74–78PubMedCrossRef
14.
Zurück zum Zitat Green DP, McCoy H (1979) Turnbuckle orthotic correction of elbow flexion contractures after acute injuries. J Bone Joint Surg Am 61:1092–1095PubMed Green DP, McCoy H (1979) Turnbuckle orthotic correction of elbow flexion contractures after acute injuries. J Bone Joint Surg Am 61:1092–1095PubMed
15.
Zurück zum Zitat Schultz-Johnson K (2002) Static progressive splinting. J Hand Therapy 15:163–178CrossRef Schultz-Johnson K (2002) Static progressive splinting. J Hand Therapy 15:163–178CrossRef
16.
Zurück zum Zitat Muller AM et al (2013) Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies. J Shoulder Elbow Surg 22:1146–1152PubMedCrossRef Muller AM et al (2013) Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies. J Shoulder Elbow Surg 22:1146–1152PubMedCrossRef
17.
Zurück zum Zitat Einhorn TA, O’Keefe RJ, Buckwalter JA (2006) Orthopaedic basic science: foundations of clinical practice, 3rd edn. American Academy of Orthopaedic Surgeons, Rosemont Einhorn TA, O’Keefe RJ, Buckwalter JA (2006) Orthopaedic basic science: foundations of clinical practice, 3rd edn. American Academy of Orthopaedic Surgeons, Rosemont
18.
Zurück zum Zitat Lindenhovius AL, Doornberg JN, Brouwer KM, Jupiter JB, Mudgal CS, Ring D (2012) A prospective randomized controlled trial of dynamic versus static progressive elbow splinting for posttraumatic elbow stiffness. J Bone Joint Surg Am 94:694–700PubMedCrossRef Lindenhovius AL, Doornberg JN, Brouwer KM, Jupiter JB, Mudgal CS, Ring D (2012) A prospective randomized controlled trial of dynamic versus static progressive elbow splinting for posttraumatic elbow stiffness. J Bone Joint Surg Am 94:694–700PubMedCrossRef
19.
Zurück zum Zitat Szekeres M (2006) A biomechanical analysis of static progressive elbow flexion splinting. J Hand Therapy 19:34–3818CrossRef Szekeres M (2006) A biomechanical analysis of static progressive elbow flexion splinting. J Hand Therapy 19:34–3818CrossRef
20.
Zurück zum Zitat Gallucci GL, Boretto JG, Davalos MA, Donndorff A, Alfie VA, De Carli P (2011) Dynamic splint for the treatment of stiff elbow. Shoulder Elbow 3:52–55CrossRef Gallucci GL, Boretto JG, Davalos MA, Donndorff A, Alfie VA, De Carli P (2011) Dynamic splint for the treatment of stiff elbow. Shoulder Elbow 3:52–55CrossRef
21.
Zurück zum Zitat Charalambous CP, Morrey BF (2012) Posttraumatic elbow stiffness. J Bone Joint Surg Am 94:1428–1437PubMedCrossRef Charalambous CP, Morrey BF (2012) Posttraumatic elbow stiffness. J Bone Joint Surg Am 94:1428–1437PubMedCrossRef
Metadaten
Titel
The use of dynamic orthoses in the treatment of the stiff elbow
verfasst von
Gerardo L. Gallucci
Jorge G. Boretto
María A. Dávalos
Verónica A. Alfie
Agustín Donndorff
Pablo De Carli
Publikationsdatum
01.12.2014
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 8/2014
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-014-1419-y

Weitere Artikel der Ausgabe 8/2014

European Journal of Orthopaedic Surgery & Traumatology 8/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.