Publication: Turnbuckle orthoses in elbow flexion contractures
Abstract
Dirsek eklem hareket açıklığı kırık, dislokasyon ve yumuşak doku yaralanmaları sonrası sıklıkla kısıtlanabilir. Bazı olgularda bu durum yoğun rehabilitasyona rağmen sürebilir. İnatçı dirsek fleksiyon kontraktürlerinin konservatif tedavisi konusunda yayınlar az sayıdadır. Bu çalışma yoğun rehabilitasyona rağmen düzelmeyen dirsek fleksiyon kontraktürlü 9 vakada menteşeli ortez uygulamalarımızın sonuçlarını bildirmektedir. Hastaların ortalama yaşı 30.2±19.4 tür. Ortez uygulama süresi ortalama 13 ±4.2 haftadır. Uygulamaya travma sonrası ortalama 21.6±6.8 hafta içinde başlanmıştır. Limitasyon nedenleri 6 vakada fraktür, 2 vakada yumuşak doku hasarı ve l vakada da intraartiküler kırıktır. Sekiz vakada tam ve tama yakın düzelme sağlanmış, ortalama ekstansiyon kazancı 31.9±10 derece olmuştur. İntraartiküler kırığı olan tek vaka ortezi tolère edemediğinden sonuçlara dahil edilmemiştir. Sonuçlarımız menteşeli ortezlerin inatçı dirsek fleksiyon kontraktürlerinde etkin bir yandaş tedavi yöntemi olabileceğine işaret etmektedir.
Fractures, dislocations and soft tissue injuries of the elbow commonly lead to range of motion limitations. In some of the patients range of motion can be corrected with appropriate physical modalities and exercise programs. However, in some patients intractable elbow flexion contractures occur in spite of intensive rehabilitation. There is very little literature on conservative care of intractable elbow flexion contractures. This study presents results of our turnbuckle splint applications in nine patients with elbow flexion contractures who did not improve despite intensive rehabilitation programs. The average age of our patients was 30.2 ±19.4 (range: 15-62). The orthosis was applied as long as possible every day for an average of 13 ±4.2 weeks. The application was begun approximately 21.6±6.8 weeks after the initial trauma. Causes of limitation were fractures in 6 cases, soft tissue injury in 2 cases and an intraarticular fracture in one patient. There was complete or near complete correction in 8 of the patients. The average gain in extension was 31.9±10 degrees. The patient with an intraarticular fracture could not tolerate the orthosis because of pain and was not included in the final assessment. Our results point out that the use of turnbuckle orthoses may be considered an efficient conservative treatment method in the correction of intractable elbow flexion contractures.
Fractures, dislocations and soft tissue injuries of the elbow commonly lead to range of motion limitations. In some of the patients range of motion can be corrected with appropriate physical modalities and exercise programs. However, in some patients intractable elbow flexion contractures occur in spite of intensive rehabilitation. There is very little literature on conservative care of intractable elbow flexion contractures. This study presents results of our turnbuckle splint applications in nine patients with elbow flexion contractures who did not improve despite intensive rehabilitation programs. The average age of our patients was 30.2 ±19.4 (range: 15-62). The orthosis was applied as long as possible every day for an average of 13 ±4.2 weeks. The application was begun approximately 21.6±6.8 weeks after the initial trauma. Causes of limitation were fractures in 6 cases, soft tissue injury in 2 cases and an intraarticular fracture in one patient. There was complete or near complete correction in 8 of the patients. The average gain in extension was 31.9±10 degrees. The patient with an intraarticular fracture could not tolerate the orthosis because of pain and was not included in the final assessment. Our results point out that the use of turnbuckle orthoses may be considered an efficient conservative treatment method in the correction of intractable elbow flexion contractures.