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ELBOW CONTRACTURE


WHAT YOU SHOULD KNOW

The word contracture simply means that full movement of a joint is prevented by the soft tissues surrounding the joint. This differs from movement being prevented by the bones of the joint. The main soft tissue associated with a joint is the membrane that surrounds the joint and contains its fluid. This membrane is called the joint capsule.

MEDICAL HISTORY

An elbow contracture typically occurs following previous elbow trauma: fracture or ligament injury. The timing of the original injury relative to the loss of motion is very important to understanding why the motion was lost. All the details of the previous treatment including prior surgery and therapy efforts should be reviewed.

EXAMINATION

The most important part of the examination is trying to determine if the underlying joint is stable and properly shaped with healthy cartilage. A joint that does not have healthy cartilage or that is already unstable will not fare well during contracture treatment. The elbow joint is measured in its four directions of movement: flexion, extension, supination, and pronation. The joint is checked for stability of its two main ligament groups (medial and lateral). Adjacent nerve compression (particularly the ulnar nerve going to the ring and small fingers) must be sought out prior to treatment as it will only get worse if not included in the plan.

ADDITIONAL TESTS: The main additional test needed is simply a basic x-ray. Rarely should expensive imaging studies such as a CT scan or MRI be needed in the work-up. If there is any question regarding ulnar nerve compression, a nerve conduction test should be performed to measure the exact nerve conduction velocities.

TREATMENT OPTIONS

  NON-OPERATIVE CAPSULECTOMY
CONSISTS OF Outpatient and home motion exercises and splinting Surgically removing the scarred capsule tissue that limits elbow motion
FEATURES Static progressive splint adjusts to push motion to the limits Must preserve the medial and lateral collateral ligaments; transpose the ulnar nerve if compressed
ADVANTAGES Avoids surgery Most powerful treatment to restore motion
DISADVANTAGES Only effective while post-traumatic scar tissue is still maturing (less than 4 months after the original trauma) Very painful and requires intense therapy commitment on the patient’s part

RECOVERY

The capsulectomy surgery removes all the previous motio


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  • I am really happy with my experience. I always knew what was going on and over time got to know the staff based on how many times I've been here. Most importantly, I feel I got the right treatment for my injury. - 10/19/17
  • I was very impressed with how I was treated by the doctor as well as the Medical assistant. All my questioned were answered and I was treated with care and respect. Luis was Awesome! Doctor Henry was very informative. I will recommend him to friends and family - 06/09/17
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  • The visit was good - 09/27/18
  • I appreciated everyone being friendly and professional and quick and competent at what they do. Dr Henry is straightforward and clear with no extra b/s and I was quite pleased with that. - 09/20/18
  • Fantastic. Very helpful and considerate staff and manner. Very much appreciated. Fully recommend in for the future. Thanks, Andrew - 09/19/18
  • I appreciate the expertise and experience of Dr. Henry!!! I know I had the BEST hand surgeon!!! - 05/02/18
  • I was so impressed that Dr. Henry took so much time with me, explaining the whole process of my injury, what should have happened, and what we can do going forward. Thank you! - 09/28/18
  • Dr. Mark Henry is a true healer; the finest most competent doctor I've ever encountered. I am forever grateful to Dr. Henry and the entire staff for saving my finger and facilitating my complete recovery with grace and seriousness of intent. Thank you. - 01/10/18
  • Thank you for sewing me back together and guiding me through my recovery!!! - 05/15/18
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  • I couldn't be more pleased with the level of service I received while in Dr. Henry's care. The level of detail in which my injury was explained and resolved, and the level of competency that was displayed throughout the healing was truly outstanding. - 01/30/18
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  • David, Luis and the staff were so helpful and answered all my questions. Highly recommend the facility for any hand surgeries. - 09/27/18
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  • The staff is nice and everyone is up on the treatment. I feel confident that I am getting the best care and am glad I came here. - 10/30/17
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  • The doctor and staff are the best I have ever had. Very professionalism at its best. - 11/15/17
  • Thank you all very much, Everyone was kind and helpful. Dr. Henry did excellent in always explaining the process of the care as well as the injury itself. - 12/14/18
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  • Very nice staff and surgeon. Thumb looks good now after surgery, hopefully thumb continues to heal and stays healed. Thank you - 01/30/18
  • Thank you for repairing my injury and being kind in the process. - 01/10/18
  • you were very good, thank you very much - 05/17/18
  • Dr.henry knew his stuff. he was friendly but straight to the point. - 09/11/18
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  • Great Doctor and staff. Luis is a wonderful asset to the staff - 12/18/17
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  • Great job your staff is the best,thank you &GOD Bless all of you! - 06/15/18
  • With the severity of my injury I am amazed at how functional my wrist is with the amazing team work shown at the office. From the very start the service and care have been outstanding!! I can't thank everyone enough! - 02/23/18
  • best place for treatment of hand and wrist problems. Dr. Henry was recommended to me by a friend who is a medical care professional. - 10/06/17
  • The staff and the Dr. are very helpful and understanding .I have not yet seen a better staff like this office . I will recommend any one here . - 11/06/17
  • Great experience on every visit. Doctor Henry's work is fantastic and his explanations are thorough. I recommend him highly whenever the opportunity presents. - 09/26/18
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  • MD was very thorough and spent a good amount of time with the patient (me). MD had good bedside manners which you do not see from a lot of doctors nowadays. He also made sure everything was understood and that I was given a chance to ask questions or address any concerns I had. Everyone was courteous and professional. Thank you for making mu visit a pleasant one. - 05/02/18
  • Outstanding service and results - 10/30/17
  • Dr. Henry and his staff are amazing! I was able to get an urgent new patient appointment immediately with surgery that same afternoon. Dr. Henry does an excellent and thorough job explaining my injury and the healing process. Very impressed with his plan of early mobility and physical therapy, which helped restore my function back to normal within 8 weeks of surgery. I would 100% recommend Dr. Henry and his staff! Very pleased and grateful for his help. - 03/23/18
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  • no complaints hand is coming along very well - 11/06/17
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  • Dr. Henry and his staff are phenomenal. Dr. Henry has a gift for not only treating health issues extremely effectively, but he is extremely thorough and very efficient at communication and explaining everything he is doing and all of clearly outlining your options for future procedures. - 05/11/18










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