Elbow Contracture

[admin]

yes and there are others. just talk to as many as you can and getting other opinions is always in order. also just because it came back or some of the contracture returned over the years doesn't mean it will be the case for your child. I think many are pleased. I am wondering how many kids are still being splinted every night, even after the surgery to prevent the contracture from returning? Has anyone had the bicep surgery done, and a few years have gone by with no return, without splinting every night?

thank you for any information

[katep]

Biceps are not the only muscle that can cause an elbow contracture. There are elbow flexors in the forarm that can also cause elbow contracture. Contractures of the biceps usually go with a more supinated (palm up) forarm position, since the biceps tend to supinate the forarm when they work. Contractures of the brachioradialis in the forarm usually go with a more pronated (palm down) position, since the BR muscle is strongest when the forarm is neutral or pronated. Also, if the joint is held flexed with a contracture for a long period of time, the joint capsule itself can become shortened and contracted and may need to be released.

Joshua was developing a perpetually flexed elbow at one point. He was holding his elbow bent with his forarm pronated. I found out about the brachioradialis problem and started doing his elbow extension stretches while applying pressure and massage to the tight muscles in his forarm. Only then did he start relaxing and fully extending his elbow, plus he also relaxed his wrist so I could stretch out his pronators, too. After about a month of stretching and massaging like that and he no longer held his elbow flexed all the time. His hand position also improved.

I strongly recommend anyone doing elbow extensions to check out the forarm for bulging or tight muscles and try to get them to relax those muscles, too.

Kate

[tnmoore]

I am a 32 yr LOBPI and I have been searching this out for myself as my contracture is at a 80 degree contracture. I have been told by many doctors that a bicep lengthening will not work for me-it may be different for a child but for an adult the elbow capsule has become very tight and needs to be released. I am planning on having that done in April at the Mayo Hospital. Plus I was always told that the contracture would come back before going to Mayo because after surgery you develop scar tissue and that is why contractures happen again. At Mayo they have a machine that they put you in right in the recovery room and it continually moves your elbow non-stop for 6 weeks 24/7 so scar tissue will not build up and cause the contracture again. If you think about it it makes sense because going to physical therapy your elbow is getting moved at intervals throughout the day and so the times that the elbow is not moving the scar tissue could build up. Where with continual movement it does not have time to scar. Plus when I discussed this issue with Dr. Nath he told me that the bicep lenghtening was the only thing he knew of and that bothered me because he did not know of the other options for releasing an elbow contracture- so make sure you get all the information you can before going through any surgery. Ask elbow specialist as well as brachial plexus specialist. Two brachial specialist recommended an elbow specialist for me and told me that was who I needed to see for my problem and they were right.....

[admin]

thank you for sharing the info about the Mayo Clinic and seeing an elbow specialist. This is important information for me to have and I am glad you mentioned the importance of looking at all options. I do not believe any one doctor is truly an expert in every procedure. I will be looking into this. Thank you.

[salcav]

My daugter is 13 years old and has grown four inches in the past year. Her elbow contracture is now at 40 degrees, much worse than it used to be. I think it is due to a como of her growth spurt and weak tricep.

She has been sleeping in a ultraflex brace for the past week that gives her a prolonged stretch overnight.
We are told that we should be seeing an increase of a degree or two per week.

Fighting this elbow contracture has been battle for us and I think this brace will be a great help.

Sally

[admin]

Sally,

Glad you got the brace. With regular use and increased tension it should help, at least to some degree. Wishing you the best!