elbow open release | Kemble Wang Orthopaedics

Elbow open contracture release for stiffness

You or your child have just undergone an elbow open contracture release with Kemble. This means that you had stiffness of the elbow that was impairing your function. The scars and/or bony problems inside the joint were addressed to try and relieve the stiffness.

You will have one or more incisions on your elbow through which the work was done. These would be on either the inside or outside of your elbow. The incisions will have sutures holding it closed. These would be dressed with water resistant dressing, on top of which bandage would have been applied. There is typically no plaster used.

Shortly after your surgery, you may be asked to use a "continuous-passive motion" machine, which the physiotherapist will help you apply. This machine assists with the motion of your elbow in the early hours following surgery.

Postoperatively your arm will be in a sling. You can start coming out of the sling straight away with the physiotherapist for exercises. When not doing your exercises, please remain in the sling until Kemble lets you know you can come out of it.
It is normal to have some tingling or numbness or weakness following your procedure. This is often due to a nerve block performed preoperatively to help with your pain, or with postoperatively injected local anaesthesia. This will wear off in the first day or two.
It is very important post-operatively that you work with your therapist immediately in trying to regain motion. You will need to start moving your elbow straight-away to get the best result
Please keep your dressing/bandage dry at all times. You may use a plastic bag tied above the elbow to prevent the dressing/wound from getting wet during shower/bathing
The outer bandage around your elbow may be removed after 3-4 days. There will still be water resistant dressing underneath - please leave these intact until around 2 weeks.
Around 2 weeks following surgery, you should have your wound checked. There may be sutures that need to be removed by a doctor or a nurse.

Therapy and movement

Starting immediately after surgery, It is important you come out of the sling to try to move your elbow. Bend and straighten your elbow all the way or as much as you can. Do 10 repetitions of this and do this 10 times a day (100 reps)
Moving the elbow may be uncomfortable or a little painful, however, it is important you still try to move it.
Most of the time, Kemble will organize for you to see a therapist to help with movement of the elbow and gradual strengthening. This should start within the first week after surgery.
In some open elbow contracture release surgery, Kemble may have had to release and then repair ligaments in the elbow as part of the procedure. This may involve the lateral ligament (LUCL) or the medial ligament (MCL). If this was done, weaning process out of sling will be slower, and you may be instructed to perform exercises while lying on your back, bending your elbow with your arm above your head (supine overhead elbow flexion/extension exercises).

Return to activity and sports

The speed of healing and return to sports is different for everyone. It is also dependent on your therapist's input.
Following surgery, you should limit weight-bearing to 5kgs for the first 6 weeks.
Once near full range of motion has been achieved, you may return to gentle sports training that does not involve throwing or weight-bearing of the arm.
For gymnasts, at 6 weeks you may begin to return to "non-flight" gymnastics. This means activities where one part of the body is always touching either the ground or the equipment. If this is well tolerated and there is no pain or locking of the elbow, you may return to full gymnastics at 3 months following surgery.
For throwers, at 2 months you may begin to return to throwing.

What to look out for

Continued drainage from the wounds that does not stop after 1 week
Suddenly deterioration in pain when previously pain has been improving
Sudden locking of the elbow and inability to bend/straighten
If any of the above is noted, please contact Dr Kemble Wang's team.