Static progressive stretching using a turnbuckle orthosis for elbow stiffness: a prospective study.

PURPOSE To assess the effectiveness of a turnbuckle orthosis as a means of improving the range of motion in patients with elbow stiffness. METHODS 17 males and 11 females aged 8 to 68 (mean, 32) years underwent static progressive stretching using a turnbuckle orthosis for elbow stiffness secondary to trauma or surgery. Patients were instructed to wear the orthosis during the daytime for a mean of 15 hours and remove it during sleep as well as at breakfast, lunch, and dinner. One hour of range-of-motion exercise was performed during each break. Patients were followed up every month and the range of motion was recorded with a standard goniometer. The use of orthosis was discontinued when there was no further improvement. Range-of-motion exercise was encouraged thereafter to maintain the results. The extent of flexion contracture and range of motion before and after the treatment were compared. RESULTS The mean duration of orthosis use was 5 (range, 3-8) months. The mean flexion contracture reduced from 59 degrees to 27 degrees and the range of motion improved from 57 degrees to 102 degrees. 19 of the patients achieved a functional range of motion. Improvement in the range of motion was excellent in 6 patients, good in 11, satisfactory in 7; at the end of follow-up (mean, 29 months), the results were maintained or improved further in 20 patients (even in those with long-standing contractures). CONCLUSION Static progressive stretching using a turnbuckle orthosis is reliable and cost-effective for treating elbow stiffness.