In elbow stiffness, pre-operative assessments should identify the articular and peri-articular tissues involved and, more specifically, they should determine how preserved the articular surfaces and osteo-articular congruity are.We will focus on the most important conditions and tissue reactions after trauma in order to understand the causes of joint stiffness.A logical surgical planning is based upon a deep knowledge of the anatomical obstacles and of the associated lesions that the trauma provoked with.The peri-articular soft tissue contractures.The osteo-articular incongruity.