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What is Post-traumatic Stiffness?

Medically, stiffness refers to difficulty moving a joint due to loss of the joint’s range of motion which may be caused by an injury (trauma) or a conditions such as arthritis

Post-traumatic stiffness is caused by trauma and results in reduced or loss of motion of a joint and functional impairment.

Post-traumatic stiffness in your elbow will make it difficult for you to bend or straighten the elbow and perform daily activities. Post-traumatic stiffness can be extrinsic or intrinsic.

Causes of Post-traumatic Stiffness

The major causes of post-traumatic stiffness in the elbow can be:

  • Bone fracture in the elbow
  • Previous surgery to the joint
  • Loose bodies in the elbow
  • Mal-union (improper healing of a fractured bone)
  • Bone dislocations in the joint
  • Heterotopic ossification (bone growth in non-skeletal tissues)
  • Cranial trauma (injury to brain, skull, or scalp)

The cause of post-traumatic elbow stiffness is the basis for its diagnosis and treatment.

Symptoms

  • Limited motion of the elbow
  • A feeling of a locked elbow
  • Pain in the elbow

Diagnosis

Evaluation of your medical history coupled with a physical examination of the affected elbow is the first step in the diagnosis of post-traumatic stiffness. An X-ray (radiograph), a CT scan or an MRI may also be ordered to confirm the diagnosis.

What are the Nonoperative Options?

Splinting (static or dynamic) of the elbow will be the first line of treatment. Other options can be:

  • Occupational therapy or physical therapy
  • Serial casting of the joint
  • Movement exercises
  • Passive mobilization
  • Manipulation under anesthesia

What are the Operative Options?

If nonoperative options do not produce results, your doctor may consider surgical procedures such as:

  • Open arthrotomy and capsular release
  • Arthroscopic lysis of adhesions
  • Osteophyte excision and/or removal of loose bodies
  • Interposition arthroplasty
  • Corrective osteotomy

These procedures, however, carry a few post-operative risks such as damage to nerves or blood vessels, bone fracture and returning stiffness.

What Happens After Your Surgery?

After the surgery, your elbow may be splinted for a short period of time to rest the tissues and minimize bleeding and/or swelling. Once the splint is removed, a compression dressing will be applied. Ice be used for 20 minutes every one to two hours during the first 72 hours to minimiz pain and swelling.

Your Rehabilitation

Postoperative rehabilitation plays a critical role in the outcome of your surgery and every patient needs an individualized approach for the best result.

Rehabilitation may involve use of a continuous passive motion machine for flexion-extension. You will also be instructed on active and passive range of motion exercises. Physical therapy will likely be needed to assist with regaining your motion. After six weeks, you may be asked to start static progressive splinting to increase motion. Splinting, therapy and home exercises should be continued until a plateau is reached.

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