Year: 2026 | Month: April-June | Volume: 11 | Issue: 2 | Pages: 37-42
DOI: https://doi.org/10.52403/ijshr.20260205
Static Progressive Orthotic Intervention for Arthrofibrosis Following Internal Fixation of Elbow Medial Condyle and Capitellum Fractures
Dibya Ranjan Swain1, Priyasmita Naik1, Prakash Chandra Prusty2, Gayatree Kumari Bhutia3, Vidhupriya K K4, Abbas Ali T K5
1Lecturer, Prosthetics and Orthotics, National Institute of Physical Medicine and Rehabilitation, Kerala,
1Lecturer, Prosthetics and Orthotics, National Institute of Physical Medicine and Rehabilitation, Kerala,
2Assistant Manager, Prosthetics and Orthotics, Sai Rehabilitation, Kerala,
3Demonstrator, Prosthetics and Orthotics, National Institute of Physical Medicine and Rehabilitation, Kerala,
4Associate Professor, National Institute of Physical Medicine and Rehabilitation, Kerala,
5Executive Director, National Institute of Physical Medicine and Rehabilitation, Kerala
Corresponding Author: Dibya Ranjan Swain
ABSTRACT
This clinical case study examined the orthotic management of post-traumatic elbow stiffness in a 15-year-old male following a right medial condyle fracture and comminuted capitellum fracture. Despite successful surgical stabilization via open reduction internal fixation, the subject presented with significant arthrofibrosis, restricted passive range of motion limited to 110 degrees, and secondary finger flexion stiffness.
The intervention focused on the application of a turnbuckle-type static progressive elbow splint that integrated the wrist and hand. The scope of the treatment involved utilizing a static progressive stretching mechanism to apply low-load, prolonged tension to the periarticular tissues. This approach aimed to facilitate stress relaxation and maintain the range of motion gains achieved during manual physiotherapy sessions. The inclusion of the distal joints addressed the extrinsic flexor length-tension relationship to prevent permanent claw-like resting postures.
Findings indicated that the turnbuckle design provided a controllable, non-elastic force that was well-tolerated by the adolescent patient, which enhanced treatment compliance and allowed for measurable progress tracking. The multi-joint orthotic approach effectively addressed both the primary injury site and secondary distal complications. In conclusion, the integration of static progressive orthoses into post-surgical protocols proved to be an effective evidence-based strategy for transitioning restricted joints toward functional range of motion.
Keywords: Post-traumatic elbow stiffness, Static progressive orthoses, Turnbuckle splint, Arthrofibrosis, Stress relaxation