Continuous passive motion versus immobilization. The effect on posttraumatic joint stiffness.
Management of intraarticular fractures is often complicated by joint stiffness long after bony healing has occurred. The following experiments provide biomechanical evidence for the effectiveness of CPM in maintaining joint function in stabilized articular injuries. The ankles of ten adolescent New Zealand white rabbits were penetrated by Steinmann pins to create an intraarticular injury. One limb of each animal was immobilized, and the contralateral limb was placed in a continuous passive motion (CPM) machine for three weeks. Joint stiffness of each ankle was quantified with an arthrograph before injury and after three weeks of treatment. Hindlimb volumes were recorded before injury and monitored at weekly intervals using a water-displacement method. Joint stiffness increased 2.6 times the preinjury levels in limbs that were immobilized for three weeks. There was no statistically significant increase in joint stiffness in ankles treated with CPM compared to preinjury values. The posttraumatic difference between the CPM-treated and immobilized limbs was highly significant; limb swelling was not affected by CPM.
Namba
R S
RS
Wadsworth Veterans Administration Medical Center, Division of Orthopaedic Surgery, Los Angeles, CA.
Kabo
J M
JM
Dorey
F J
FJ
Meals
R A
RA
D000818:Animals; D016512:Ankle Injuries; D000843:Ankle Joint / Q000503:physiopathology*; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation; D050723:Fractures, Bone / Q000628:therapy*; D007717:Knee; D015915:Motion Therapy, Continuous Passive / Q000295:instrumentation; D011817:Rabbits; D016059:Range of Motion, Articular / Q000502:physiology