Functional elbow range of motion 6 months after contracture release and ORIF K-wire in elbow stiffness with malunion capitellum and neglected radial head and ulnar dislocation: a case report

Highlights

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  Elbow joint stiffness is relatively common following injury to the elbow.

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  This case is very devastating due to loss of overall arm function due to traumatic elbow stiffness.

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  We managed to restore ROM of elbow joint to the functional level after traumatic stiffness.

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  This combination technique of surgery provides excellent outcome for the patient.

Abstract

Introduction

Elbow stiffness is the most common complication following trauma of the elbow. This is because the elbow joint is susceptible to effusion, hemarthrosis, scarring, and capsule thickening due to its small intracapsular volume. Surgical treatment is therefore necessary to release soft tissue contracture.

Case

A male teenager was unable to flex his elbow since 1 year prior to admission after falling down during football practice. He didn’t seek any medical treatment and had his elbow massaged since 5 months ago. On physical examination, his right elbow was extended, with flexion-extension range of motion (ROM) of 30 ⁰ - 0 ⁰. On the radiograph, there was malunion fracture of left capitellum and neglected posterosuperior dislocation of radial head and ulna. Surgery was performed to release contracture and correct the malunion. Normal activity with functional elbow flexion-extension ROM of 110 ⁰ - 30 ⁰ was achieved in 6 months after operation.

Discussion

Elbow stiffness is a challenging case for surgeon, especially in regards of developing good perioperative plan. The aim of treatment for elbow stiffness is to achieve a pain-free and functional elbow ROM.

Conclusion

To achieve functional elbow ROM, surgical treatment was necessary to release the contracture. In addition, the etiology of trauma must be thoroughly investigated and a good rehabilitation program must be integrative to the treatment.