Post-traumatic stiff elbow: key statistical data
published in November - December 2017 - in Il Fisioterapista - issue n.6
Massimo Bitocchi

Objective: To investigate the statistical data reported in the literature regarding post-traumatic stiff elbow.
Introduction: Trauma is a common cause of stiffness of the elbow joint. Elbow stiffness is defined as flexion <120° and loss of extension >30°. Capsule contractures can be prevented by early active mobilization following any trauma of the elbow. Nonsurgical treatment such as physiotherapy, dynamic splinting, and static progressive splinting is recommended and should be continued for at least 6 months; if conservative treatment fails, surgical arthrolysis is indicated.
Method: We searched the current literature for relevant studies, without employing a specific methodological criterion for identifying and analyzing the literature (this is not a systematic review).
Results: The data presented show a mean gain in motion of 40° for arthroscopic arthrolysis vs. 88° for open arthrolysis combined with external fixation. The complication rates conversely are 5% and 73%, respectively, for arthroscopic arthrolysis and open arthrolysis with external fixation.
Conclusion: In the current literature on post-traumatic stiff elbow, the level of evidence of studies is 3 or less. Given that the number of complications increases with the level of surgery carried out, the surgeon should be as little invasive as possible; however, open release is the treatment of choice in very stiff elbows.