Elbow contractures can arise due to any of the following reasons

• Elbow trauma & fractures
• Elbow surgery
• Osteoarthritis
• Rheumatoid arthritis
• Loose bodies
• Osteophytes or bone spurs
• Malunions of fractures
• Joint infection
• Burns

Symptoms of Elbow Contracture include the following:

• Stiffness of the elbow
• Inability to fully extend or flex the arm
• Usually no pain is associated with elbow contractures.

Elbow contracture is diagnosed based on patient’s medical history, thorough clinical examination and appropriate investigations like elbow X-rays, MRI, CT scan and nerve conduction studies. These investigations help in planning appropriate treatment for the patient based on the cause for elbow contracture.

Elbow contracture can be managed conservatively or surgically

Conservative Treatment:

Conservative treatment options for elbow contracture are successful for most elbow contractures of less than 6 months duration. These options will be based on patient’s particular situation and may include the following:

• Elbow Physiotherapy helps to stretch the elbow tissues, improve joint mobility and elbow function.
• Splinting
• Casting
• Manipulation under anaesthesia may be needed in some patients to break joint adhesions and improve mobility

Surgical treatment:

If conservative treatments fail to improve the elbow contracture despite extensive physiotherapy by the patient, then surgery may be recommended.

Arthroscopic Elbow Capsular Release is a minimally invasive surgical procedure done through tiny incisions to release the contracture associated with elbow stiffness.

This surgery can also be performed through a large open incision.

Capsular Release is a surgery performed under general or regional anaesthesia as a day care or 1 day stay surgery.

Dr Jadhav will decide which surgical technique will be used for you based on your situation.

The care after release of elbow contracture is as follows:

• There will be a bulky dressing bandage around the elbow. This helps in reducing swelling and bleeding.
• A tiny catheter is left in the axillary / armpit area. This is used for giving pain relieving medications (blocks). It also helps in early mobilisation of the elbow without much pain.
• Oral anti-inflammatory medications are also taken as needed for first 5 to 10 days for pain relief.
• Continuous passive motion is started next day under supervision of a physiotherapist.
• The elbow is kept in a sling when resting. Aggressive elbow range of motion exercises are started as pain allows. Patient needs to be under the care of an experienced physiotherapist for regaining elbow range of motion faster.
• Regular ice packs are applied 4 to 5 times a day. During resting or sleeping, a pillow is used to elevate and support the operated elbow. These measures help reduce elbow region swelling and pain.
• The surgical wounds are kept clean and dry until suture removal after 10 to 12 days. Regular bathing can start after this.
• Patients are strictly advised against smoking. They are encouraged to eat a healthy diet. This will help in wound healing.

Arthroscopic Elbow Capsular Release is a safe procedure that rarely involves any major complications. The possible complications are: swelling, bleeding, bruising, infection, damage to nerves or blood vessels, inability to achieve complete release of contracture, need for prolonged physiotherapy and recurrence of stiffness.