Korean Medicine Treatment Including Acupotomy for Post-Traumatic Elbow Range-of-Motion Limitation After Comminuted Olecranon Fracture: A Case Report

Background: Post-traumatic limitation of elbow range of motion (ROM) after comminuted intra-articular olecranon fracture results in persistent pain and disability, particularly in patients treated without internal fixation.This case report describes functional recovery after Korean medicine treatment including acupotomy in a nonoperatively managed comminuted olecranon fracture.Case presentation: A 67-year-old man sustained an elbow dislocation with comminuted intra-articular olecranon fracture that was managed without internal fixation.From 6 to 10 weeks after injury, he received 4 weeks of rehabilitation and Korean medicine treatment including acupuncture and herbal medicine, but severe pain and limitation of elbow ROM persisted.The patient reported a pain intensity of 8 on the numeric rating scale (NRS).The elbow ROM was limited to 22 of extension and 92 of flexion, and the Mayo Elbow Performance Score (MEPS) was 40, classified as 'poor'.Intervention and outcomes: From 10 weeks after injury, the patient discontinued conventional rehabilitation and received Korean medicine treatment including acupotomy for 7 months.A total of 81 outpatient sessions were delivered, comprising 39 sessions of acupotomy targeting the olecranon and medial epicondyle regions and 42 sessions of acupuncture and electroacupuncture.These treatments were supplemented with pharmacopuncture, herbal medicine, and Korean physical therapy.By the end of treatment, pain and paresthesia had resolved (NRS 0), ROM improved to 13 extension and 132 flexion, and MEPS increased to 100.Follow-up radiographs demonstrated solid bone union with callus formation, and no serious adverse events occurred.Conclusion: In this nonoperatively managed comminuted olecranon fracture with posttraumatic limitation of elbow ROM, Korean medicine treatment including acupotomy achieved marked pain relief, restoration of elbow motion, and favorable functional recovery without serious safety concerns.