Contractures due to post-fracture/injury

What is it: Contracture of the elbow can be described as a stiff elbow joint. It won’t move all the way into flexion, extension, or both. Sometimes the person has trouble turning the hand palm up or palm down. The cause can be from something intra-articular (inside the joint) or extra-articular (outside the joint).

Statistics: Stiffness of the elbow impairs hand function, because this is highly dependent on elbow extension and flexion and forearm rotation. A 50% reduction of elbow motion can reduce the upper extremity function by almost 80%

Important Facts: Trauma and heterotopic ossification (HO) are the most likely causes of elbow contractures. Elbow dislocations and damage to the nerves are the most common results of elbow trauma. HO is the formation of calcified bone in the soft tissue. It is another potential consequence of elbow injury. But HO can also occur as a result of head injury, burns, and Paget’s disease. Genetics may also play a role in HO. These are extra-articular conditions that do not occur directly in the elbow but affect the elbow.

Treatment Duration: Whenever possible, prevention is the main focus of management for elbow contracture. Exercise and splinting can help prevent loss of motion after trauma. Patients with known risk factors for HO should be treated prophylactically. This means treatment is given ahead of time to prevent the problem from ever occurring. Non-steroidal anti-inflammatory drugs (NSAIDS) and low-dose radiation are used as preventive agents most often.