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Adhesionlysis for Stiffness of Elbow Joint

Adhesiolysis is the surgical procedure performed to remove or divide adhesions. By removing the adhesions, normal joint function is restored and the symptoms that cause pain can be relieved. Adhesion is a band of scar tissue that establishes initially as part of the body’s natural repair mechanism to counter any tissue disturbances like:

  • Trauma
  • Surgery Infections
  • Trauma Radiation
  • Pathologies like endometriosis

In some cases, adhesions can form without any visible or known tissue trauma. Some adhesions form as part of the natural healing process, some others can develop as excessive scar tissues not proportional to the injury. Adhesions can bind to the organs or tissue and cause pain, dysfunctioning of the organ and other symptoms.
Elbow stiffness can result from bone perturbations, soft tissue or both. The analysis of the elbow stiffness is done based on its classification, diagnosis, prevention and treatment. In most of the cases, soft tissues called adhesions can lead to stiffness by restricting the elbow motion physically.


Non-Surgical Treatment
The different non-surgical treatment options include:

  • Static and Dynamic Splinting
    Static splints like turnbuckle splint can help in recovering the elbow’s range of motion.
  • Physical Therapy
    The doctors will recommend exercises to help in increasing the elbow’s range of motion.
  • Manipulation of the stiff elbow can also increase elbow motion by 55%
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): like Ibuprofen etc., can help reduce the pain and swelling.

Surgical Treatment
The doctors decide on surgery based on the elbow function and the patient’s wellbeing. The doctors might go for surgery if the flexion contractures lag greater than 30 degrees. The surgeons will need to perform the surgical procedure keeping the following factors in mind:

  • Close proximity of the neurovascular structures
  • Minimize the soft tissue trauma
  • Analyze the fracture reduction, stability and intraoperative gains in the range of motion.

The surgeons usually prefer using the Elbow Arthroscopy surgical technique to take care of the bone that blocks the elbow’s motion and the soft tissue contracture about the elbow. This technique uses arthroscopic osteophyte excision; loose body removal and capsulectomy that will help improve function and decrease pain.

Elbow Arthroscopy
This is a minimal invasive surgical procedure performed to diagnose and also treat stiff elbows.

The procedure involves the doctor in creating couple of incisions and inserting the tiny camera called the Arthroscope, which will act as a visual aid for the doctors in performing the procedure. The doctors will first examine the injured area and then insert thin surgical instruments through the other incisions and all the adhesions can be released , any abnormal scar tissues and boney overgrowths can also be excised at the same time . since arthroscopic adhesiolysis is a minimally invasive procedure , recovery is fast and near completete.



Authored by Dr Banarji B.H - Shoulder Surgeon, Bangalore

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Baby Das

Last one year I was suffering from acute shoulder pain on my left shoulder. I went to several doctors, but not diagnosed.

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