Stiffness is a common and poorly tolerated complication of elbow trauma. Hinged elbow braces are commonly utilized to allow safe early mobilisation to prevent stiffness. Braces control the range of elbow flexion and extension while providing relative protection against valgus and varus forces. The maximal instability of the elbow is typically in extension so braces usually limit extension while allowing the maximum degree of flexion. The functional elbow range is from 30° to 130°, but up to 150° of flexion is required for phone use. Many hinged elbow braces only accommodate 120° of flexion, potentially precipitating stiffness in flexion. To evaluate if a fully unlocked hinged brace restricts elbow flexion. We included 30 elbows in 15 healthy candidates. Maximum flexion for each participant was measured using a digital protractor. Measurements were repeated with the hinged elbow brace applied. Demographic and morphometric data, including age, height, weight, BMI, mid-forearm circumference and mid-upper arm circumference were recorded. The application of the brace resulted in a reduction in flexion compared to measurements taken out of brace. A Paired sample t-test revealed a mean difference of 30.0° (p < 0.001). Reduction in flexion did not correlate with age, BMI, gender, or upper and forearm measurements. Hinged braces limit flexion. Surgeons should be aware of the limitations of such braces. An appropriate physiotherapy protocol including exercises out of brace allowing safe full flexion may be required to avoid post-operative stiffness and the resultant decreased patient satisfaction.
Kotze et al. (2026) studied this question.