Elbow joint contracture after traumatic injury

Introduction: The purpose of the study was to follow elbow range of motion for I year after injury and to document the rate of secondary intervention due to joint contracture. Methods: We prospectively followed up 25 subjects with traumatic elbow injuries. Data were collected up to 52 weeks after injury. Injuries at the elbow included fractures, elbow dislocations, fracture-dislocations, and biceps tendon ruptures. Subjects were treated as their injury necessitated, with a rehabilitation protocol for each injury type. Results: There was significant improvement for all range-of-motion measures for the time course to 1-year follow up (P < .05). At 1 year, 22 of 25 subjects achieved a flexion-extension arc greater than 100 degrees. At I year, 24 of 25 subjects achieved a pronation-supination arc greater than 100 degrees. Reoperation was performed in 5 of 25 subjects; in 3 of which, this was because of elbow joint contracture. Conclusions: Traumatic elbow injuries carry a risk of joint contracture, 12% of our subjects did not regain a functional range of motion, and 12% had a joint contracture that required reoperation. Range of motion continues to improve up to 1 year after injury; failure to progress 3 months after injury suggests impending elbow joint contractures. Level of evidence: Level IV, Case Series, Prognosis Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.