Portal de Periódicos da CAPES

Static Progressive Splinting for Posttraumatic Elbow Stiffness

2006; Lippincott Williams & Wilkins; Volume: 20; Issue: 6 Linguagem: Inglês

10.1097/00005131-200607000-00006

1531-2291

Job N. Doornberg, David Ring, Jesse B. Jupiter,

Shoulder Injury and Treatment

Objectives To determine the value of static progressive splinting in helping patients with posttraumatic elbow stiffness regain functional motion and avoid operative treatment for stiffness. Design Retrospective case series. Setting Level I Trauma Center. Patients and Intervention Over a 3-year period, 29 consecutive patients with elbow stiffness after trauma (flexion contracture greater than 30 degrees or flexion less than 130 degrees) were treated with static progressive elbow splinting when a standard exercise program was no longer achieving gains in motion. Three patients were treated after the injury alone; 14 were treated after operative treatment of the initial injury, and 12 after a secondary operative contracture release for posttraumatic stiffness. Splinting was initiated on an average of 55 days (range, 15 to 200 d) after injury or operative treatment. Main Outcome Measurements Ulnohumeral range of motion before and after splint treatment. Results The flexion arc improved from 71 degrees (range, 0 to 100 degrees) before splinting to 112 degrees (range, 20 to 150 degrees) after splinting. After splinting, 3 patients had a flexion contracture greater than 30 degrees and 10 patients (34%) had fewer than 130 degrees of flexion. Only 3 patients—2 with heterotopic bone and 1 with an associated ulnar neuropathy—requested an operation to address elbow stiffness. Patients who were splinted after the initial injury (n=17, average improvementfl−ext=51±37 degrees) regained greater motion during splint wear than patients treated after elbow capsulectomy (n=12, average improvement fl−ext=22±24 degrees). Conclusions Static progressive splinting can help gain additional motion when standard exercises seem stagnant or inadequate, particularly after the original injury. Operative treatment of stiffness was avoided in most patients.