Supporting the treatment of post-traumatic contractures of the elbow by serial casts holding the joint in extreme flexion and extension successively: a case study

Stanisław Junk, Piotr J Biliński, Wojciech Hagner, Jan Talar

Stanisław Junk, Piotr J Biliński, Wojciech Hagner, Jan Talar – Supporting the treatment of post-traumatic contractures of the elbow by serial casts holding the joint in extreme flexion and extension successively: a case study. Fizjoterapia Polska 2003; 3(3); 277-280

Abstract

Background. The treatment of post-traumatic contracture is beset with many difficulties, caused in large part by the anatomical complexity of this joint. Case histories. This article presents three patients treated for persistent post-traumatic contracture of the elbow. The rehabilitation problem consisted in the fact that when extenion was increased, flexion was decreased, and vice versa. In order to overcome this mechanism, which maintained an unchanged range of movement by alternately shifting the extreme positions of flexion or extension, we attempted to increase the total range of movement by using plaster extensors to fix the progress of maximum movement. Plaster casts holding the joint in the maximum, extreme position were changed every two hours. Therapy with physical agents and mild exercises was simultaneously administered. New pairs of double casts were made twice, each time achieving further improvement. Conclusions. In selected cases of contractures resistant to standard rehabilitation procedures, when the use of a redressing rail is impossible, the method of serial casts in alternating extreme redressment as here described should be considered.

Key words:
post-traumatic spasticity, ulnar joint, conservative treatment
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