Elbow Stiffness and its Management
The elbow is a complex synovial joint consisting of hinge and pivot components. In addition to the humero-ulnar shape, the medial and lateral collateral ligaments, with the anterior and posterior capsule provide static stability; the elbow flexors and extensors are the dynamic stabilizers. Flexion restricted to less than 120 degrees and loss of extension of over 30 degrees constitutes stiffness of the elbow, which maybe caused by traumatic and atraumatic conditions. Elbow stiffness maybe extrinsic, or intrinsic. The management includes nonoperative, followed by operative measures, including arthroscopic release, open arthrolysis, arthroplasty (interposition, distraction, total joint replacement) and excision of heterotopic ossification. The management of elbow stiffness is very difficult and challenging and so its prevention is very important.