Mobilization brace in post-traumatic elbow stiffness

Abstract

Invalidating elbow contractures, a frequent problem after injury, are commonly treated by physical therapy or surgical release. In both cases, results can be frustrating: physical therapy is often not sufficient to gain functional range of motion, and after surgical release it is common to lose part of the motion gained in operating room. Thanks to the viscous-elastic properties of the soft tissue, the mobilization elbow braces can stretch the retracting or retracted tissues inducing a biological lengthening of collagen fibres. In post-traumatic contracture, mobilization braces are effectively employable in two main critical situations: to treat recent onset contractures which do not respond to simple physical therapy and to help in preserving range of motion gained after surgical release. We report our experience with mobilization brace used in 42 patients, 5 for post-traumatic contracture, 4 for contracture following articular fracture fixation and 33 after surgical release. Classification, indications and treatment protocols of the mobilization braces utilized are reported.

Posttraumatic Elbow Stiffness

“…Braces for improving elbow motion are either dynamic or static progressive types 50 . Dynamic splints have an adjustable spring exerting a constant stretching load, set to an extent not producing pain.…”

“…Biological tissues show viscoelastic properties including creep and stress relaxation. Dynamic splinting is based on creep (an increase in length with the application of a constant load for prolonged time 50 ) and static progressive splinting on stress relaxation (a decrease in load required to maintain a certain length over time).…”

The use of braces in the rehabilitation treatment of the post-traumatic elbow

“…Elbow stiffness is a very disabling complication because it impedes the fundamental role of the elbow: placing the hand in space. Furthermore, elbow stiffness is rarely accepted by the patient due to the lack of useful compensation in the over-and underlying joints (9). A 50% reduction of elbow ROM can cause an at least 80% loss of function of the upper limb (10).…”

Elbow Rehabilitation

“…Their drawbacks/ Sports Injuries DOI 10.1007/978-3-642-36801-1_55-1 # Springer-Verlag Berlin Heidelberg 2014 disadvantages are their cost, the need of medical assistance, and the patient's diligence. In order to be successful, the treatment has to be performed in team and requires to obtain the patient's diligent responsibility (Marinelli et al 2010). …”