The elbow joint cannot bend

Our elbows can bend freely, making our upper limbs very flexible. To put it simply, the inability of the elbow joint to bend means that its function is restricted. The reason for this phenomenon is generally due to elbow ankylosis. Of course, the specific situation also requires understanding the characteristics of elbow ankylosis and making a comprehensive judgment based on one's own situation. After figuring out the cause, timely treatment should be carried out.

Various reasons cause partial or complete loss of elbow joint movement, which fixes the elbow joint in a specific position. This is called elbow ankylosis, which can be generally divided into fibrous stiffness and bony ankylosis.

Causes

Elbow ankylosis is mainly related to the following factors: ① Elbow fracture: especially improper reduction after intra-articular fracture. ②Myositis ossificans. ③ Soft tissue adhesions such as muscles, tendons, ligaments and joint capsules can cause extensive and severe adhesions. ④ Improper treatment after elbow joint trauma, such as long-term fixed forceful activity massage therapy, etc. ⑤Elbow joint infection.

Clinical manifestations

1. Elbow ankylosis

Elbow extension is reduced by 30° and flexion is less than 120°.

2. Elbow pain, which worsens at night or during functional exercise

The elbow joint is stiff in the morning, and the range of motion increases after functional exercise.

3. Symptoms of ulnar nerve irritation during elbow flexion and extension

That is, when the elbow joint is extended and flexed, there is soreness, discomfort and pain in the elbow and forearm, and it radiates to the 4th and 5th fingers. The above symptoms disappear after nerve block anesthesia. Or there were symptoms of ulnar nerve irritation in the past, but now the joint range of motion is very small, the muscles innervated by the ulnar nerve are atrophied, etc., or Wartenberg sign and Froment sign may be found.

4. Elbow ankylosis gradually worsens

Conventional functional exercises, Chinese medicine fumigation, massage and drug treatment still cannot stop the progression.

5. X-ray, MRI or CT examination

This may indicate shallowing and narrowing of the ulnar nerve groove or the presence of osteophytes.

treat

1. Conservative treatment

For fibrous ankylosis, physical therapy can be tried, including active exercise and physical therapy. This is effective for those with early intra-articular adhesions. Avoid forceful passive extension and flexion. Exercise training under violent conditions may aggravate joint stiffness.

2. Surgery

It is a reliable method for treating elbow ankylosis. It is usually performed between 4 and 6 months after injury. If surgery is performed too early, the myositis ossificans may become stiff again due to the fact that the joint has not yet been cured; if surgery is performed too late, the soft tissue around the joint may contract and adhere, which may reduce its elasticity and lead to poor results.

Surgical methods include:

(1) Elbow arthrolysis;

(2) Elbow arthroplasty, such as fascioplasty and elbow resection;

(3) Elbow arthrodesis, etc.