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I need Help for elbow joint.
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I need Help for elbow joint. - December 2, 2004 6:44:00 AM
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Soravee
Posts: 8
Joined: March 28, 2004
From: Bangkok, Thailand
Status: offline
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I have a patient who have a stiffness of the right elbow 1 years ago.ROM Flexion 120 degrees, extension -20 degrees. I need the treatment for my patient. I used Hot pack and mobilization in technique disraction and PA. but it is not improve for the ROM. I don't know what should I do? [EMAIL]k_vac@hotmail.com[/EMAIL]
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S. Phrueksawan
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Re: I need Help for elbow joint. - December 2, 2004 6:55:00 AM
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jma
Posts: 2414
Joined: August 24, 2000
From: NY
Status: offline
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Hello,
It would be helpful to know what was the cause of the stiffness in the elbow to begin with. Was it a fracture that was casted for a certain period of time? Or could it have been blunt trauma that caused the initial injury. Has X-rays been taken? Sometimes after an injury to the elbow, osteophytes can set in and make it very hard for the normal arthokinematics of full flexion and extension to occur. Very hard to treat and would perhaps warrant a orthopedic consultation.
JMA
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Re: I need Help for elbow joint. - December 2, 2004 9:52:00 PM
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Soravee
Posts: 8
Joined: March 28, 2004
From: Bangkok, Thailand
Status: offline
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Thanks for the reply.
But in case, He have an injury after badminton game for a year ago.I was treated him by contact relax. After treatment the ROM are increase in flexion 125 degree, extension -10 degree. What should I do more?
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S. Phrueksawan
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Re: I need Help for elbow joint. - December 3, 2004 3:20:00 AM
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FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
Status: offline
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typically this is a frustrating joint sp don't get down on yourself. Since the typical carrying angle is that of somehwat flexion about 30 degrees. the elbow rarely gets straightened in daily activities so these contracted joints occur frequently and are a pain in the ass to get rid of. A dynamic splint is not a bad idea. I willuse a towel to distract while they go in arom, ala mulligan technique. make sure you mob the radial ulna as well as the ulnar humeral. If there is any fixation device present inside I would say this is about what this person will have for range give or take 5 degrees on either sdie. You may get them to 5-135 but I can almost guarantee you that in one year they'd be back to just about this. A contracted joint this old does not respond well to contract relax in my opinion/experience. IT is a bit more brute mobs, manip if appropriate, and VERY good patient compliance about possibly using body weight to gain flexion and dynamic splint for extension. mob it in supination, neutral, pronation. But dont beat yourself up on this one, especially with today's insurance where you may get to see him 2 times a week for 3 weeks don't expect too much. Sorry for being a pessimist..err realist....ortho consult though is def. in order if you do not have the patient compliance necessary. Last question: functionally is this limiting him from doing anything?
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Re: I need Help for elbow joint. - December 5, 2004 8:58:00 AM
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Soravee
Posts: 8
Joined: March 28, 2004
From: Bangkok, Thailand
Status: offline
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Thanks FLAOrthoPT for the reply. I will try to treat my patient. And Thanks for encourage me too.
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S. Phrueksawan
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