Wednesday, May 25, 2022

Re: Elbow flexion contracture

John Wallace, CO

I have had success with a custom molded elbow orthosis with the Monodos
joint which is distributed by Becker. Use the heaviest hinge, since
over time I have found that the lighter model will sometimes slip.
Keever Wallace, CO

—–Original Message—–
From: T Jarrott
To: [email protected]
Sent: Wed, 20 Apr 2005 20:32:18 +1000
Subject: [OANDP-L] Elbow flexion contracture

Dear colleagues,

I have recently seen a 30 year old female who had a cererbral aneurysm
around 2
years ago. As a result she has very high increased tone especially in
her upper
body. In particular her right elbow is maximally flexed, shoulder
adducted and
internally rotated. She can be passively stretched out to about 100
degrees off
full extension with much force. This severe flexion position obviosuly
creates
some issues with personal care and skin integrity in the cubital fossa.
She has
sought surgical opinion but is not keen to proceed with this for now.
Past
Botox and serial casting have made some improvements but only
temporarily. Some
orthotic options have been tried by other orthotists with various
problems in
the past and currently the physio. uses ‘second skin’ garments with an
elbow
wedge (however these aren’t very satisfactory). She is now due to have
another
round of Botox and serial casting and then we hope to put her in a
definitive
elbow brace to maintain / imrove the position acheived. Any
suggestions as to
the most likely successful option? I am, thinking that a custom elbow
orthosis
with either ratchet hinge or a turnbuckle system might be best. Thanks
for your
replies.

Tim Jarrott
Orthotist / Prosthetist
Australia

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