Elbow joint rigidity

　　Elbow joint rigidity refers to the loss of movement of the elbow joint due to various causes and its fixation at a specific position. Its occurrence is often caused by the following reasons:

　　1. Fracture of the elbow, especially improper reduction after intra-articular fracture.

　　2. Osteoarthritic myositis.

　　3. Widespread and severe adhesions caused by injuries to muscles, tendons, ligaments, joint capsules, etc.

　　4. Inadequate treatment after elbow joint trauma, such as long-term immobilization, forceful activity, and massage therapy.

　　5. Elbow joint infection.

　　Elbow joint rigidity is a common sequelae of elbow trauma. During the treatment process, due to the long-term immobilization of the affected limb, adhesions occur between the joint, muscles or tendons around the joint, and the ligaments and fascia, eventually leading to joint rigidity. Traditional Chinese medicine massage and acupuncture therapy are effective for mild rigidity patients, but ineffective for patients in the middle and late stages. Although there are various surgical procedures in Western medicine, the surgery is invasive, and it is impossible to avoid the adhesions, scars, and contractions brought by the surgery itself. In severe cases, due to scars and adhesions, the only function of the preoperative elbow joint may be completely lost, which is also a common complication of this disease.

　　The elbow joint can become rigid in any position, with the most common being the flexed position, accounting for about 2/3; the extended position is about 1/3. Regardless of the position of rigidity, it causes severe functional impairment of the elbow joint. X-ray examination can help analyze the causes of elbow joint rigidity.The diagnosis of ulnar-origin elbow joint rigidity has the following criteria:.

　　1. Elbow joint extension decreases by 30°, and flexion is less than 120°, which is considered elbow joint rigidity.

　　2. Elbow joint pain intensifies at night or during functional exercises. The morning stiffness of the elbow joint is relieved after functional exercises, and the range of motion increases.

　　3. There are symptoms of ulnar nerve stimulation during the extension and flexion of the elbow joint, that is, there is discomfort and pain in the elbow and forearm during the extension and flexion of the elbow joint, and it radiates to the 4th and 5th fingers. After nerve block anesthesia, the above symptoms disappear. The patient may have had symptoms of ulnar nerve stimulation, but now the joint mobility is very small, the muscles innervated by the ulnar nerve atrophy, or the Wartenberg sign and Froment sign may be found.

　　4. Elbow joint rigidity shows a gradually worsening trend, and conventional functional exercises, traditional Chinese medicine fumigation and massage, and drug treatment still cannot stop its development.

　　5. X-ray, MRI, or CT may show shallowing, narrowing of the ulnar groove, or osteophytes.

　　The prevention of elbow joint rigidity mainly involves taking some positive preventive measures against the causes, and it is also necessary to pay attention to the hand function exercises for patients undergoing surgical treatment.After manual treatment, the elbow joint is first passively flexed and extended every day, and if conditions permit, CPM can be used, the range of motion is from small to large, and try to reach the maximum range that can be reached. Then let the patient actively flex and extend the elbow joint, and the degree is bearable and not tired. At the same time, instruct the patient to exert force at any time to perform various activities of the hand, wrist, and shoulder..

　　Elbow stiffness has characteristic clinical manifestations, so diagnosis is not difficult. Clinically, auxiliary examinations are mainly used to distinguish the etiology, such as for patients with ulnar elbow stiffness, X-ray, MRI, or CT may show shallowening, narrowing, or osteophytes of the ulnar groove. Clinically, appropriate auxiliary examination methods should be selected according to the patient's clinical symptoms and the suspected etiology.

　　It is very important to pay attention to diet in daily life after suffering from elbow stiffness, and it is forbidden to eat cold and raw foods. Elbow stiffness diet can be cooked with drugs such as Astragalus, prepared Rehmannia, Angelica sinensis, and Chinese wolfberry with meat and other foods as food therapy (eat meat and drink soup). Foods high in fiber, protein, and cellulose are the first choice for patients with stiffness, and dietary therapy is particularly important for patients with elbow stiffness. Elbow stiffness diet can also consult a nutritionist to match the most suitable diet for the patient.

　　Conventional external washing formula for elbow stiffness is 20g of Uncaria rhizoma, 15g each of tendinous grass, bone-breaking grass, alisma, clematis, Chinese clematis, mulberry branch, cassia twig, 10g each of mugwort leaves, su木, selaginella, and phellodendron. Place the above herbs in a basin, add 1000-1500ml of water. After boiling, place the affected elbow on the basin, cover with a towel, and steam for 15 minutes (be careful to prevent burns). Remove the fire and continue to steam until the liquid is warm, then place the affected elbow in the basin for a bath for 30 minutes. While washing, gently massage the acupoints of Shizhu, Quze, Tianjing, and elbow bone, and perform active flexion and extension activities. Do this 2-3 times a day, for 3 days per dose. After steaming and washing, the soft tissue of the elbow joint becomes soft, and massage is mainly performed with kneading, pulling, grasping, rubbing, and flexion and extension methods.