A new static progressive splint for treatment of knee and elbow flexion contractures

Abstract

Background: Knee and elbow flexion contractures are a frequent cause of ambulation and function problems that often require extensive rehabilitation. Traditional methods are of limited benefit in severe and fixed contracture. A new static progressive splint was developed from daily-use knee and elbow orthosis and a newly invented gradual telescopic rod, which is designed to provide low load, and gradual and prolonged stretching.

Material and method: The splint was used in ten cases (11 knees) of knee flexion contracture and three cases of elbow flexion contracture. There were multiple etiologies of contracture such as burn scar contractures, intra-articular fractures, septic arthritis, juvenile rheumatoid arthritis, and immobilization. The average timing of the contracture before splinting was 14.6 months (range, 2 to 36) in the knee group and 16.7 months (range, 6 to 30) in the elbow group.

Results: The average initial extension was -53.6 degrees (range, -30 to -85) in the knee group and -70 degrees (range -65 to -80) in the elbow group. The average post treatment extension was -15 degrees (range, 0 to -30) in the knee group and -38.3 degrees (range, -30 to -45) in the elbow group. The average duration of treatment was 9.2 weeks (range, 4 to 16) in the knee group and 14 weeks (range, 11 to 20) in the elbow group. The most dramatic result was found in the patient who had burn scar flexion contractures of both knees for 20 months. The knee extensions increased from -60 and-85 degrees to full extension in four and 14 weeks after treatment, respectively. There were no recurrences or complications from the use of this splint. The patients were able to easily adjust the gradual telescopic rod themselves to provide the appropriate force for stretching.

Conclusion: The static progressive splint is a new, effective, and low cost method for treatment of knee and elbow flexion contracture from multiple etiologies. The excellent result was found in extra-articular contracture.