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3 months after ORIF of a distal humerus fracture with a flexion arc of 45° to 100° with no further improvement with physical therapy
71%
1615/2268
4 weeks after nonoperative treatment of a displaced radial head fracture with block to supination
7%
166/2268
1 week after simple elbow dislocation with flexion arc of 10° to 140°
11%
255/2268
Presence of extensive heterotopic ossification after a complex elbow dislocation with associated ankylosis of the joint
5%
111/2268
Immediatly after elbow arthroscopy for loose body removal and debridement
4%
96/2268
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Static progressive splinting is useful treatment for certain patients with post-traumatic elbow stiffness. Generalized accepted indications are flexion contractures greater than 30 degrees, or flexion less than 130 degrees after a failed trial of physical therapy. Gelinas et al treated 22 patients with an elbow contracture using a static progressive turnbuckle splint for a mean of 4.5 months. Eleven patients gained a 'functional arc of movement,' defined as at least 30 degrees to 130 degrees, and only 3 patients showed no improvement at all. Doornberg et al treated 29 consecutive patients with elbow stiffness after trauma (flexion contracture greater than 30 degrees or flexion less than 130 degrees) who had failed therapy. The flexion arc improved from 71 degrees before splinting to 112 degrees after splinting. Operative treatment of stiffness was avoided in most patients. Incorrect Answers: 2-Progressive turnbuckle splinting is typically not indicated for mechanical blocks to motion, especially in the supination/pronation plane. 3-A functionally physiologic flexion arc of 10-140 degrees is not an indication for turnbuckle splinting, as it will likely not be improved with this treatment. 4-An ankylosed joint will not benefit from progressive turnbuckle splinting. 5-Turnbuckle splinting is not typically prescribed after elbow arthroscopy for loose body removal. An example of a turnbuckle splint is shown in Illustration A.
3.4
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