Elbow flexion contractures treated with serial casts and conservative therapy

We report on the technique of serial casts to successfully reverse elbow flexion contractures in three patients. Patients considered for this technique had a traumatic injury to the elbow that resulted in residual soft tissue restrictions; their mean flexion deformity was 44 degrees, which had been present for an average of 6 months. Treatment consisted of traditional therapy methods to obtain initial stretch and elongation of tissue followed by application of a cylindrical fiberglass cast in the position of maximal elbow extension. The cast was worn for 3 to 5 days, then removed, and the entire process was repeated. After the use of serial casts, elbow flexion contractures were reduced to a mean of 11 degrees. These results have been maintained over an average of 26 months. The use of casts in the treatment of elbow flexion contractures appears to be a viable technique for increasing range of motion when traditional methods of treatment alone are unsuccessful and surgical intervention may be the only alternative.