الفهرس 
Anatomy and Biomechanics of the ElbowOnly 14 pages are availabe for public view
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Abstract
The elbow is one of the most important joints of the upper limb because it places the hand in space from or towards the body. It provides the linkage, allowing the hand to be brought to the trunk, head or mouth.
The normal flexion extension arc ranges from 0 to 145° and the arc of pronation supination ranges from 85° of supination to 75° of pronation. This range far exceeds what is normally required for activities of daily living, which usually ranges from 30° extension to about 130° flexion and required supination pronation is 50° either way.
Elbow joint stability is provided by joint surface congruency, static soft tissue stabilization including that of the medial and lateral collateral ligaments and dynamic stabilization including that of the flexor and extensor muscles attaching to the epicondyle. As a result of its specific anatomy, the elbow in particular is prone to developing serious injuries resulting in stiffness and limitation of motion.
Elbow stiffness may be classified as either intrinsic, extrinsic or mixed causes and as mild, moderate or severe; and the diagnosis can only be complete after a detailed patient history and clinical examination coupled with the necessary imaging studies to help decide the appropriate management.
Prevention of the contracture development is the ideal solution for our problem through early motion and avoidance of aggressive manipulation. Once stiffness has occurred however, non-operative management should be sleeked as the first resort through supervised physical therapy, including the use of splints. Should non-operative treatment fail we should turn to operative management as a final resort using the severity of degenerative changes and pathological classification as our guide on operative decision.
For patients with mild or no degenerative changes (extrinsic contractures), soft tissue release, arthroscopic or open is usually adequate. Moderate arthritic changes (intrinsic causes require) debridement or Outerbridge-Kashiwagi ulnohumeral arthroplasty or arthroscopic debridement and severe intrinsic cases require fascial interposition and/or distraction arthroplasty or even total elbow arthroplasty.Selected case may also benefit from triceps lengthening, synovectomy, manipulation under anaesthesia or radial head excision. Heterotopic calcification which commonly accompanies post-traumatic elbow stiffness requires excision.
Postoperatively Cooperation and compliance are required from all surgical candidates in completing an intensive physical rehabilitation program to achieve and maintain a good range of motion following intervention.