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.