Elbow Contracture

What is Elbow Contracture?

Elbow contracture refers to a stiff elbow with a limited range of motion. It is a common complication following elbow surgery, fractures, dislocations, and burns.

The normal functional range of motion for an elbow is 30-145 degrees. A stiff or contracted elbow may be diagnosed when the ability to extend or flex the arm is lessened by 30 degrees or more. Flexion contractures greater than 45 degrees will significantly affect your ability to perform activities of daily living such as bathing and eating.

Symptoms of Elbow Contracture

The symptoms of elbow contracture include the following:

• Stiffness of the elbow
• Inability to fully extend or flex the arm
• No associated pain usually

Causes of Elbow Contracture

The causes and risk factors associated with elbow contracture include:

• Elbow trauma
• Elbow surgery
• Osteoarthritis
• Rheumatoid arthritis
• Loose bodies
• Osteophytes or bone spurs
• Malunions of fractures
• Joint infection
• Burns

Diagnosis of Elbow Contracture

Elbow conditions should be evaluated by an orthopaedic surgeon for proper diagnosis and treatment. Your surgeon will review your medical history, and perform a physical examination and order diagnostic studies such as X-ray, CT scan, MRI and nerve conduction studies.

Treatment options for Elbow Contracture

Conservative Treatment for Elbow Contracture 

Conservative treatment options for elbow contracture can successfully treat most elbow contractures of less than 6 months’ duration. These options will be based on your condition and may include the following:

• Physiotherapy
• Splinting
• Casting
• Manipulation

Surgical Treatment for Elbow Contracture 

If conservative treatment options fail to improve the elbow contracture despite your adherence to physiotherapy, surgery may be recommended.

Capsular release is a surgical procedure to release the contracture associated with elbow stiffness. This surgery may be performed through a large, open incision or arthroscopically through much smaller incisions. Arthroscopic elbow capsular release is a minimally invasive surgery performed in a hospital operating room under general or regional anaesthesia.

Your surgeon will discuss the options with you and decide which surgical technique will be best for your condition.

Postoperative Care after Elbow Capsular Release

After surgery, your surgeon will give you instructions to follow depending on the type of repair performed. Common postoperative care following elbow contracture release includes the following:

• Initially, you will have a lightly wrapped, bulky bandage from your shoulder to your hand to minimise swelling and bleeding.
• A catheter will be placed and left in the axillary or armpit area for administering a brachial plexus block anaesthetic for pain relief.
• Continuous passive range of motion will begin within a day after surgery.
• Elevate the elbow on a pillow and applying ice packs over the dressing to help reduce swelling.
• Keep the incisions clean and dry. You may shower once the dressings are removed unless otherwise directed by your surgeon.
• You will be given specific instructions regarding activity and rehabilitation. It is imperative that you comply with physiotherapy directions for the best outcome from your surgery.
• Eating a healthy diet and quitting smoking will promote healing.

Risks and Complications after Elbow Capsular Release

Arthroscopic elbow capsular release is a safe procedure that rarely involves any major complications. Some possible complications may include infection and nerve damage.