Static-progressive bracing is associated with improved range of motion in patients with post-traumatic and post-operative elbow stiffness at three months

Background: 

Elbow stiffness after trauma or surgery remains challenging to treat, with limited consensus on optimal approaches. Treatment efficiency could be improved by identifying patients likely to benefit from nonsurgical treatment. Therefore, this cohort study assessed short-term changes in elbow ROM and patient-reported outcome measure (PROM) scores during static-progressive bracing in patients with post-traumatic or post-operative elbow stiffness. 

Methods: 

We included patients with symptomatic limited elbow flexion and/or extension, indicated for brace therapy. Elbow motion (flexion, extension, total motion arc), PROM-scores, and treatment satisfaction were collected at baseline and at three months. Differences were analyzed using paired t-tests. Possible predictors for poor treatment outcome (≤10° improvement at three months) were identified using univariate regression. 

Results: 

Twenty-nine patients were included. Statistically significant improvements were observed for flexion, extension deficits, total motion arc, and PROM-scores (OES and Quick-DASH). However, both PROM-scores did not surpass the minimal clinically important difference. Overall treatment satisfaction was 56%. Age emerged as a possible predictor for poor treatment outcomes in extension deficits. No brace-related complications were observed.

Discussion: 

While increasing age may reduce efficacy in patients with extension deficits, static-progressive bracing appeared safe and was associated with early improvement in ROM in patients with post-traumatic or post-operative elbow stiffness and should be considered in all patients.