Elbow Dislocations, Instability and Contracture-Stiffness and Contracture Overview

Stiffness and Contracture Overview

Pdf Summary

Chapter 20 of the document discusses stiffness and contracture in the hand, wrist, and elbow. It explains that digital stiffness can be caused by factors such as Dupuytren contracture, nervous system disorders, congenital disorders, and post-traumatic or rheumatologic changes in the bone or joint. The chapter focuses on stiffness resulting from trauma, swelling, or immobilization without changes in bone morphology. It describes the pathoanatomy of hand stiffness and how contractures become fixed in certain joint positions. It also explains the structure and function of the digital extensor and intrinsic extensor mechanisms. The chapter then discusses the evaluation of a stiff digit, including the difference between active and passive motion and the identification of barriers to flexion and extension. It provides a systematic approach to evaluating the components limiting joint motion and offers treatment options, such as nonoperative therapy with orthoses and surgical treatment for cases that do not improve with therapy. The chapter also briefly discusses wrist stiffness, its minimum functional range of motion, and management options, including physical therapy and surgical treatment. Additionally, it provides an overview of elbow stiffness, its anatomy, causes, evaluation, and surgical treatment options, such as open contracture release and arthroscopic release. The chapter concludes with a discussion of complications and postoperative care.

Keywords

stiffness

contracture

hand

wrist

elbow

digital stiffness

Dupuytren contracture

nervous system disorders

congenital disorders

post-traumatic changes