Postoperative Elbow Stiffnes
Conditions
Interventions
Manipulation under anesthesia combined with rehabilitation therapy:Patients randomly assigned to the intervention group will undergo manual release under anesthesia for elbow stiffness (MUA), followed
Sponsors
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1.Age >=18 years (with skeletal maturity), with no upper age limit, provided the patient meets medical criteria for anesthesia tolerance. 2. History of acute elbow fractures (including distal humerus, proximal ulna [olecranon], and/or proximal radius [radial head/neck] fractures) treated with open reduction and internal fixation (ORIF), which may be accompanied by elbow dislocation. Documentation of the fracture and surgical procedure (operative reports, imaging records) must be provided. 3. Persistent restricted range of motion (ROM) 3–6 months post-ORIF, defined as a flexion-extension arc 30° and/or flexion 30°). Written records must confirm ROM deficits despite standardized rehabilitation therapy. 4. Radiographic evidence of fracture union or stable fixation (no hardware loosening) 3–6 months post-ORIF, ensuring the safety of manipulative release procedures. 5. Stiffness causing difficulty in performing daily activities (e.g., inability to reach the head, eat, or maintain perineal hygiene), with baseline functional disability scores (e.g., DASH questionnaire) documented. 6. Willingness to provide informed consent, comply with the trial protocol (including randomization and rehabilitation plans), understand the intervention, and commit to 1-year follow-up.
Exclusion criteria
Exclusion criteria: 1. Imaging reveals extensive periarticular ossification bridges or severe motion restriction (requiring surgical excision). 2. Presence of bony block (e.g., complete joint ankylosis) or mechanical impingement from internal fixation devices limiting mobility (requiring surgical release). 3. Imaging-confirmed nonunion of fractures or failure/loosening of internal fixation. 4. Clinical assessment indicates significant instability (e.g., ligament injury causing subluxation/dislocation). 5. History of elbow release surgery or manipulative release following ORIF (open reduction internal fixation). 6. Moderate-to-severe ulnar neuropathy or other surgically indicated nerve injuries (mild sensory abnormalities require cautious evaluation). 7. Active infection in the affected elbow (e.g., septic arthritis); chronic infections in remission require case-by-case assessment. 8. Severe underlying conditions precluding anesthesia tolerance (e.g., unstable cardiac disease, uncontrolled hypertension). 9. Pregnancy (due to anesthesia and imaging contraindications); preoperative pregnancy testing required for women of childbearing age. 10. Inability to complete rehabilitation or follow-up (e.g., remote residence, psychiatric/cognitive impairment affecting compliance). Prisoners or others unable to guarantee follow-up are also excluded.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Percentage of ROM recovery; | — |
Secondary
| Measure | Time frame |
|---|---|
| ROM of elbow;VAS;Strength Test; | — |
Countries
China
Contacts
Public ContactHuang Lihua
Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Outcome results
None listed