Effective Solutions for Stiff Elbows and Orthopedic Concerns

Hello, Dr. Shi?

Hello, Dr.
Shi.
I apologize for bothering you again, but I have a few more questions.

1.
If the elbow stiffness has persisted for a while and rehabilitation has not shown significant results, are there any other methods to restore the elbow to its original condition?
2.
How long should metal screws be left in before removal? Can they be removed once the bone has healed? Is three months sufficient for removal?
3.
If undergoing joint mobilization therapy, how often should it be done, and how many sessions are needed to see effective results?
4.
If the arm is straightened and casted to prevent the elbow from bending, will this help restore function?
Thank you very much for taking the time to answer my questions.
I greatly appreciate it.

YYCC, 20~29 year old female. Ask Date: 2004/09/14

Dr. Shi Guozheng reply Orthopedics

If elbow joint stiffness persists for more than three months, recovery becomes more challenging; however, do not give up on rehabilitation, as there is still a chance for improvement.
After a fracture has healed, theoretically, the bone screws can be removed, but to prevent re-fracture, removal is usually delayed unless the screws interfere with joint mobility or there is inflammation or infection.
If not removed, some screws may eventually work their way out, potentially irritating the skin or soft tissue, necessitating their removal.
Joint mobilization procedures are typically performed once; if the joint is straightened and immobilized with a cast to prevent elbow flexion, it may lead to future inability to bend the elbow, so caution is advised during use.

Reply Date: 2004/09/14

More Info

When dealing with stiff elbows and orthopedic concerns, it's essential to approach the situation with a comprehensive understanding of the underlying issues and available treatment options. Here are some effective solutions and considerations based on your questions:
1. Persistent Elbow Stiffness: If you've been experiencing elbow stiffness for an extended period and rehabilitation hasn't yielded significant improvements, there are several alternative methods to consider. First, it's crucial to ensure that the stiffness isn't due to an underlying condition such as arthritis or a previous injury that hasn't healed properly. If conservative treatments like physical therapy, stretching exercises, and anti-inflammatory medications haven't worked, you might want to explore options such as corticosteroid injections to reduce inflammation or pain. In some cases, a procedure known as arthroscopy may be recommended, where a surgeon can remove scar tissue or loose bodies in the joint, potentially restoring range of motion.

2. Timing for Hardware Removal: Regarding the removal of metal hardware (like screws or plates), the timing can vary based on individual healing rates and the specific nature of the injury. Generally, if the bone has healed adequately, hardware can be removed after about three months, but this is contingent on follow-up imaging (like X-rays) confirming proper healing. It's essential to consult with your orthopedic surgeon, who can assess your healing progress and determine the appropriate time for removal.

3. Joint Mobilization Therapy: If you're considering joint mobilization therapy (also known as joint manipulation), the frequency and number of sessions required can vary widely based on individual needs. Typically, patients may benefit from sessions once or twice a week, with a total of 6 to 12 sessions being common. The goal is to improve mobility and reduce stiffness gradually. Your physical therapist or orthopedic specialist can provide a tailored plan based on your specific condition and response to treatment.

4. Using a Cast to Maintain Elbow Position: Applying a cast to keep the elbow straight may help prevent further stiffness, but it is crucial to balance immobilization with the need for movement. Prolonged immobilization can lead to more stiffness and loss of function. If a cast is deemed necessary, it should be used under the guidance of a healthcare professional, who can monitor your progress and adjust treatment as needed.

In summary, addressing elbow stiffness and orthopedic concerns requires a multifaceted approach. If conservative treatments are ineffective, consider discussing more advanced options with your healthcare provider. Regular follow-ups and imaging can help ensure that any hardware removal is timely and safe. Lastly, maintaining a balance between immobilization and movement is key to recovery. Always consult with your orthopedic specialist to create a personalized treatment plan that considers your unique situation and health history.

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