Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2019; 7(10): 1191-1199
Published online May 26, 2019. doi: 10.12998/wjcc.v7.i10.1191
Multiple rare causes of post-traumatic elbow stiffness in an adolescent patient: A case report and review of literature
Bai-Qi Pan, Jun Huang, Jiang-Dong Ni, Ming-Ming Yan, Qin Xia
Bai-Qi Pan, Jun Huang, Jiang-Dong Ni, Ming-Ming Yan, Qin Xia, Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
Author contributions: Pan BQ performed the research and follow-up, and wrote the paper; Huang J designed the research and wrote the paper; Ni JD, Yan MM and Xia Q contributed some advice to this work.
Informed consent statement: Informed consent to publish was obtained from the patient.
Conflict-of-interest statement: All authors declare no conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jun Huang, MD, PhD, Doctor, Department of Orthopedics, The Second Xiangya Hospital, Central South University, No. 139, Middle of Renmin Road, Changsha 410011, Hunan Province, China.
Telephone: +86-134-67699531 Fax: +86-731-85295126
Received: December 26, 2018
Peer-review started: December 27, 2018
First decision: March 10, 2019
Revised: March 26, 2019
Accepted: April 19, 2019
Article in press: April 19, 2019
Published online: May 26, 2019

Joint stiffness after elbow surgery is not a rare complication, and is always accompanied by deformity. The causes of joint stiffness are multiple in different patients, and divided into intrinsic and extrinsic causes. Herein, we report an unusual case of posttraumatic elbow stiffness due to multiple and rare causes.


A 19-year-old male was hospitalized with the loss of motion of the left elbow for over ten years. Left limb computed tomography revealed left elbow stiffness with bony block and connection. The patient underwent surgery, and the etiology of joint stiffness was found to be a rare combination of common and uncommon causes. During an 18-mo follow-up period, the patient’s left elbow had normal motion and he was symptom-free.


However, this case combined with multiple and rare causes highlights that the patient with scar physique is likely to be accompanied with more severe soft tissue, nerve contracture, and heterotypic ossification, even during recurrence.

Keywords: Post-traumatic, Elbow stiffness, Open surgery, Contracture, Ulnar neuritis, Radial nerve, Scar, Case report

Core tip: Elbow stiffness is a well-known complication after elbow fractures/surgeries. Common causes of elbow stiffness include intra-articular adhesions, soft tissue contracture and heterotypic ossification (HO), etc. We report a case of post-traumatic elbow stiffness due to multiple and rare causes, including a bony connection, scar keloid and abnormal radial nerve. There have been no reports regarding such factors, which made the treatment of this patient more complicated. The patient was treated successfully with surgery and had a satisfactory recovery. However, this reminds us that the patient with scar physique is more likely to be accompanied with severe soft tissue or nerve contracture, or HO, even during recurrence.