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Clin Shoulder Elbow > Volume 13(2); 2010 > Article
Clinics in Shoulder and Elbow 2010;13(2):286-292.
DOI: https://doi.org/10.5397/CiSE.2010.13.2.286    Published online December 31, 2010.
Pathophysiology of Stiff Elbow
Hyun Seok Song, Hyung Moon Yoon
Department of Orthopedic Surgery, St. Paul's Hospital, the Catholic University of Korea, Seoul, Korea. hssongmd@yahoo.com
주관절 강직의 병태 생리
송현석·윤형문
가톨릭대학교 의과대학 성바오로병원 정형외과학교실
Abstract
PURPOSE
Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. MATERIALS AND METHODS: Morrey et al. reported that the functional range of motion of the elbow joint is 30-130degrees of flexion-extension and 50degrees of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge.
RESULTS
AND CONCLUSIONS: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.
Key Words: Stiff elbow; Pathophysiology; Capsulectomy; Contracture


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