Sisir Kumar Sahoo1, A. Ganesh2, Nikhil Kumar Sureshkumar Oza3, Spandan Mishra4, Indraneel De5
Stiff elbow is a common problem associated with terrible triad injuries which if not
managed properly can lead to significant functional limitations. Here we are
describing a case of post-traumatic stiff elbow following terrible triad who
presented to us after taking native treatment primarily. He was treated with open
arthrolysis and prophylactic ulnar nerve decompression along with rigorous
physiotherapy including dynamic splinting with hinge elbow bracing. The results
were satisfactory in achieving a functional range of movement according to the
patient's vocational need. This study aims to present the prompt management of
post-traumatic stiff elbow case along with functional improvement postoperatively
in a decisive way.
Terrible triad injuries are a group of the rare and severely unstable fracturedislocations
following which the chance of recurrent instability, elbow stiffness,
and functional limitations increases coherently.1 To perform normal daily activities,
painless motion at the elbow joint is very much necessary and critical. Following a
traumatic insult, a cascade of events can lead to a decrease in the normal arc of
motion and also cause stiffness of the elbow joint.2 Over the last two decades,
there has been a lot of speculation revolving around the management of terrible
triad injuries.3 Van Riet et al had documented that the majority of the terrible triad
injuries need to be managed surgically whereas the non-operative treatment is
reserved for a few selected cases.4 The ones which were not managed adequately
had higher chances of turning up into stiff elbow. Post-traumatic elbow stiffness
is one of the dreaded complications following terrible triad injuries.3
The aim of managing the case of post-traumatic stiff elbow is to have a
painless, near-normal range of motion which can help the patient to do daily
activities by himself. We are presenting a case of post-traumatic type- 4 stiff elbow
following native bandage treatment and how prompt management has led to
satisfactory results.
