Der steife Ellenbogen – von der Theorie zur Praxis

Ohne ein bewegliches Ellenbogengelenk wäre es nicht möglich, die Hand variabel im Raum zu positionieren. Umso wichtiger ist es, nach einer Verletzung die bestmögliche Beweglichkeit wieder zu erreichen. Meistens funktioniert das auch, braucht aber Zeit. Konsens besteht darin, dass Mobilisierungen möglichst früh starten und auch psychische Faktoren adressiert werden sollten.

• Literatur

• 1 Nandi S, Maschke S, Evans PJ. et al. The stiff elbow. Hand 2009; 4: 368-379
• 2 Adolfsson L. Post-traumatic stiff elbow. EFORT Open Rev 2018; 3: 210-216
• 3 Jones V. Conservative management of the post-traumatic stiff elbow: a physiotherapist’s perspective. Shoulder Elbow 2016; 8: 134-141
• 4 Liu W, Sun Z, Xiong H. et al. What are the prevalence of and factors independently associated with depression and anxiety among patients with posttraumatic elbow stiffness? A cross-sectional, multicenter study. J Shoulder Elbow Surg 2022; 31: 469-480
• 5 Murray O, Macdonald D, Nunn T. et al. Management of the post-traumatic stiff elbow. Shoulder Elbow 2012; 4: 38-45
• 6 Attum B, Obremskey W. Posttraumatic elbow stiffness: a critical analysis review. JBJS Rev 2016; 4: e1
• 7 Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg 1981; 63: 872-877
• 8 Sardelli M, Tashjian RZ, MacWilliams BA. Functional elbow range of motion for contemporary tasks. J Bone Joint Surg 2011; 93: 471-477
• 9 Morrey BF. Post-traumatic contracture of the elbow. Operative treatment, including distraction arthroplasty. J Bone Joint Surg 1990; 72: 601-618
• 10 Watts AC, Bain GI. New techniques in elbow arthroscopy. In: Savoie FH, Field LD, eds. The Elbow and Wrist. AANA Advanced Arthroscopic Surgical Techniques. Philadelphia: Saunders-Elsevier;; 2015: 124-131
• 11 Siemensma MF, van der Windt AE, van Es EM. et al. Management of the stiff elbow: a literature review. EFORT Open Rev 2023; 8: 351-360
• 12 Myden C, Hildebrand K. Elbow joint contracture after traumatic injury. J Shoulder Elbow Surg 2011; 20: 39-44
• 13 Verstuyft L, Caekebeke P, van Riet R. Postoperative rehabilitation in elbow surgery. J Clin Orthop Trauma 2021; 20: 101479
• 14 Monument MJ, Hart DA, Salo PT. et al. Posttraumatic elbow contractures: targeting neuroinflammatory fibrogenic mechanisms. J Orthop Sci 2013; 18: 869-877
• 15 Doornberg JN, Bosse T, Cohen MS. et al. Temporary presence of myofibroblasts in human elbow capsule after trauma. J Bone Joint Surg Am 2014; 96: e36
• 16 Cohen MS, Schimmel DR, Masuda K. et al. Structural and biochemical evaluation of the elbow capsule after trauma. J Shoulder Elbow Surg 2007; 16: 484-490
• 17 Lounev VY, Ramachandran R, Wosczyna MN. et al. Identification of progenitor cells that contribute to heterotopic skeletogenesis. J Bone Joint Surg Am 2009; 91: 652-663
• 18 Adolfsson L. Post-traumatic stiff elbow. EFORT Open Rev 2018; 3: 210-216
• 19 Foruria AM, Augustin S, Morrey BF, Sánchez-Sotelo J. Heterotopic ossification after surgery for fractures and fracture-dislocations involving the proximal aspect of the radius or ulna. J Bone Joint Surg AM 2013; 95: e66
• 20 Jayakumar P, Teunis T, Vranceanu AM. et al. Psychosocial factors affecting variation in patient-reported outcomes after elbow fractures. J Shoulder Elbow Surg 2019; 28: 1431-1440
• 21 Giannicola G, Polimanti D, Bullitta G. et al. Critical time period for recovery of functional range of motion after surgical treatment of complex elbow instability: prospective study on 76 patients. Injury 2014; 45: 540-545
• 22 Jones V. Examination of the Elbow Region. In: Ryder D, Barnard K, eds. Petty’s Musculoskeletal Examination and Assessment-E-Book. A Handbook for Therapists. 6^th ed.. Elsevier; 2023
• 23 Haverstock JP, King GJ, Athwal GS. et al. Elbow motion patterns during daily activity. J Shoulder Elbow Surg 2020; 29: 2007-2014
• 24 Iordens GIT, Van Lieshout EMM, Schep NWL. et al. Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial. Br J Sports Med 2017; 51: 531-538
• 25 Reiter AJ, Castile RM, Schott HR. et al. Investigating the Effects of Physical Therapy Timing, Intensity and Duration on Post-Traumatic Joint Contracture in a Rat Elbow Model. Muscles Ligaments Tendons 2021; 11: 547-553
• 26 Manocha RH, Banayan S, Johnson JA. et al. Overhead arm positioning in the rehabilitation of elbow dislocations: An in vitro biomechanical study. J Hand Ther 2022; 35: 245-253
• 27 Wolff AL, Hotchkiss RN. Lateral elbow instability: nonoperative, operative, and postoperative management. J Hand Ther 2006; 19: 238-244
• 28 Page C, Backus SI, Lenhoff MW. Electromyographic activity in stiff and normal elbows during elbow flexion and extension. J Hand Ther 2003; 16: 5-11
• 29 Fuentes CT, Bastian AJ. Where is your arm? Variations in proprioception across space and tasks. J Neurophysiol 2010; 103: 164-171
• 30 Birinci T, Mutlu EK, Altun S. The efficacy of graded motor imagery in post-traumatic stiffness of elbow: a randomized controlled trial. J Shoulder Elbow Surg 2022; 31: 2147-2156
• 31 Fusaro I, Orsini S, Scampoli C. Elbow soft tissue recon- struction and arthroplasty: post-operative management. Soft tissue reconstruction and arthroplasty. Rizzoli Advanced Elbow Course, Bologna, Italy. 2011
• 32 Gibson J. Rehabilitation of the Elbow. In: Stanley D, Trail I, eds. Operative Elbow Surgery. 1^st ed.. London: Churchill Livingstone; 2012: 511-532
• 33 Veltman ES, Doornberg JN, Eygendaal D. et al. Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients. Arch Orthop Trauma Surg 2015; 135: 613-617
• 34 Driscoll SW, Giori NJ. Continuous passive motion (CPM): theory and principles of clinical application. J Rehabil Res Dev 2000; 37: 179-188
• 35 Carpenter CV, Amirfeyz R. Continuous passive motion following elbow arthrolysis. J Hand Surg 2014; 39: 350-352
• 36 Lindenhovius AL, van de Luijtgaarden K, Ring D. et al. Open elbow contracture release: postoperative management with and without continuous passive motion. J Hand Surg aM 2009; 34: 858-865