The Elbow

HELP : TREATMENT

I.A. injections can, for some reason, not be given.

A treatment with triamcinolone may be contra-indicated, or the patient refuses the injection.

In monarticular steroid sensitive arthritis there is no local alternative for IA injections.

In a traumatic arthritis, the injection can be substituted by rest in maximal flexion.
As soon as the patient is seen, the elbow is immobilized in as much flexion as possible by means of a 'collar-and-cuff bandage'.
Every day the elbow is flexed more, until full movement can be achieved; thereafter it is held in this position for about two weeks.

The elbow is then rested in slightly less flexion. Gradually, day by day, the elbow is allowed to extend more and wore.

After about six weeks the patient can wear the arm in a sling at 90 of flexion. During that period the elbow is regularly re-examined to check if the range of flexion is still full.

After 2 more months in this position, movements of the elbow should be full and painless.