Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
BACKGROUND: The elbow is the conduit of upper extremity actions, delivered through the shoulders to the hand. Elbow problems greatly affect daily function and quality of life of the sufferers. Here we report the use of prolotherapy as an adjunct to physiotherapy to provide a speedy range of motion (ROM) recovery in an army officer affected by neglected old unreduced elbow dislocation, which was reduced with an open reduction surgery and internal fixation of his elbow. The patient provided HIPAA compliant consent for the inclusion of their clinical information in this report.
METHODS: We used the Hackett-Hemwall technique as described in the literature. A total of 15 mL solution of 5% dextrose and 0.2% lidocaine is injected in the lateral epicondyle humerus and extensor carpi radialis brevis tendon proximally, also tender areas around the elbow about 0.5 mL to 1 mL per injection.
RESULTS: Eight sessions of prolotherapy were administered; 2 months after the last session, ROM of the elbow was 500 to 1350 and the Visual Analog Scale score decreased from 7 to 1. Patient was satisfied with the result.
CONCLUSIONS: Treating postoperative stiffness is one of the utmost precautions for postsurgical management. Particularly for chronic elbow dislocation, prevention of stiffness needs to be more progressive to treat the condition. Our case presented one alternative management where prolotherapy may provide a satisfactory outcome for pain and assist to speed recovery in a subacute surgical patient.
KEY WORDS: Prolotherapy, post operative elbow stiffness, old unreduced elbow dislocation, case report