Elbow Stiffness/Contracture

The notes on this page are written as a source of information to both patients and health professionals. It is a general overview and its content should not be seen as direct medical advice. Further information regarding diagnosis and treatment specific to your condition can be made via a consultation with Dr Amaranath.

Anatomy of the elbow

The elbow is a hinge joint allowing movements of flexion and extension. It is formed by the connection between the distal end of the humerus (made up of the capitulum and the trochlea) with the proximal end of the radius (radial head) and ulna (olecranon). The joint is surrounded by capsule which produces synovial fluid allowing for a smooth range of motion.

What is elbow stiffness/contracture? 

Elbow stiffness occurs when there is a limited range of motion to the elbow due to a bony block or thickening of the capsule. This reduces the space within the joint and limits its range of motion. This can lead to significant functional deficits with limitations in flexion worse than extension.

elbow stiffness anatomy surgery Jeevaka Amaranath Sydney Orthopaedic Surgeon

What are the common causes?

  1. Arthritis – This can lead to the formation of osteophytes (bony outgrowths), loss of cartilage and capsular tightening that can cause stiffness and limitation in movement.

  2. Post Traumatic – Injuries to the elbow can stimulate capsular thickening (due to an inflammatory response) and malunion (bone healing in the wrong position) can cause blocking of joint motion.

What are the preferred Investigations/Imaging?

  1. Elbow X-Ray - This should include an Anterior/Posterior and Lateral.

  2. CT scan of the elbow- This is commonly used to asses bone stock and help identify any evidence of loose bodies, osteophytes (bony prominences) and deformity.

What are the treatment options?

  1. Non-operative – Once a diagnosis has been obtained the first line of treatment would include non-operative measures such as analgesia, corticosteroid injections, physiotherapy and static splinting of the arm.

  2. Elbow Arthroscopy – This involves key hole surgery where we remove any loose bony fragments, shave away any bony points of impingement which may block motion and release the capsule.

  3. Open Surgical Release – In some cases the degree of contracture may be too severe for an arthroscopic procedure or there may be metalware (e.g. plates and screws used post trauma) that require removal along with a surgical release. In these cases, an open removal of hardware, excision of bone and release of capsule may be required.What does the rehabilitation/recovery involve?

What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after elbow surgery please see our Rehabilitation Protocols here.