Elbow Stiffness Surgery

Elbow Stiffness is a common problem encountered in Orthopaedic practice. It is a morbid condition that restricts a patient’s daily activities. The reasons for stiff elbow are injury, massage, fractures around the elbow, infection, burns, and rheumatoid arthritis. Mismanagement in the form of native treatment with oil massage, tight bandages jeopardizing the circulation to the arm, and splinting by quacks is a common practice in our society.

Elbow fractures are very common in children. This needs proper treatment with good reduction, fixation and early mobilization. Alternative methods and delayed treatment lead to severe stiffness of the elbow with excessive new bone formation (heterotopic ossification) and a dysfunctional useless upper limb. The stiff elbow of the right arm with the elbow straight leaves with a permanent disability if the inability to do day-to-day activities like a hand to mouth eating, dressing and face washing as the elbow cannot bend. In left arm with a stiff elbow, hand to buttock for toiletry hygiene is impossible.

This disabling problem was difficult to treat as any attempted surgical correction was bound to fail. Again due to the proximity of major vessels & nerves in the elbow it was considered dangerous to explore a stiff elbow that had a guarded prognosis. Now through various research and superior surgical techniques, better ideas have evolved in treating this difficult problem.

A NEW SURGICAL RELEASE PROCEDURE involving global soft time release as an envelope all around the bony contour of the elbow by two separate approaches with contouring of bony abnormality was described pertaining to each fracture/dislocation of the elbow and the casual factor. An accelerated active rehabilitation program in the immediate postoperative period from day one has yielded fruitful results with good functional movement. Stiff elbow post-surgery or sideswipe injuries or septic arthritis resulting in bony ankylosis of the elbow are also treated by the new concept of ” Bevelled inverted ‘V’ Osteotomy excision arthroplasty”. More than 200 patients of children & adults have benefited by this new surgical procedure.

Our research papers regarding this problem were published in various journals Indian and International Orthopaedic journals. This original research has been published in the Indian Journal of Orthopaedics. This paper was read in the American Association of Orthopaedic Surgeons 2006 meet, Chicago. The study on Heterotopic ossification in stiff elbow won the best paper award and gold medal in “INDO- GERMAN ORTHOPAEDIC MEET”. Early excision of heterotopic ossification contrary to conventional treatment in stiff elbow won the best paper, DrSurendran Gold medal award. V Osteotomy for ankylosed elbow has been published in the Journal of Orthopaedic& Research, Hongkong. Live surgical demonstration to orthopaedic delegates in National Meet on stiff elbow release has been demonstrated. This work was presented in many state, National and International level Orthopaedic conferences (Sicot- World Trauma Congress,2011) meeting. Our hospital is specialized in treating this condition and has got very good results. Patients from various parts of the country were referred to us for the treatment of elbow stiffness. Today, elbow stiffness is not the end up of the world; it can be well treated with the proven surgical method for a fruitful outcome. We emphasize spreading the awareness among public that elbow injuries need proper management and not to go for uncanny treatment like oil massage and splinters by quacks or bone setters as this may lead to deformity and stiffness. In case this happens due to any reason we have the expertise and new technology to rectify this difficult problem.