Arthrolysis in the relief of post-traumatic stiffness of the elbow

Abstract

SUMMARYA retrospective clinical study of 34 patients treated by arthrolysis for elbow stiffness is presented. These patients had sustained previous injury which was a simple fracture in 44%. The average age at operation was 31 years with a range from 6 to 57 years. Follow up for a minimum of one year, and an average of four years, showed an increase of motion from a preoperative average of 45° to a postoperative average of 92° with few complications and only three unsatisfactory results. This analysis has allowed conclusions concerning the technique and indications for operation. RÉSUMÉPrésentation de l'étude rétrospective de 34 raideurs 'du coude traitées par arthrolyse. Ces patients avaient subi un traumatisme qui n'était, dans 44% des cas, qu'une simple fracture. L'âge moyen au moment de l'opération était de 31 ans, avec des extrêmes de 6 à 57 ans. Le rectal moyen était de 4 ans, avec un minimum d'un an. On a obtenu une amélioration de la mobilité qui est passée de 45° en moyenne en pré-opératoire à 92° en moyenne après l'arthrolyse. Il n'y a eu que peu de complications et seulement 3 échecs. Cette étude permet des conclusions concernant la technique et les indications de cette opération.

Arthrolysis for post-traumatic stiffness of the elbow

“…Contraindications are active inflammation or infection, and an active stage of periarticular ossification [9,16,18,23,24]. Sympathetic reflex dystrophy, unwillingness to cooperate and lack of motivation have also been regarded as contraindications [1,22].…”

The Posttraumatic Stiff Elbow: A Review of the Literature

“…8,125,127,132,202,203 Continuous passive motion (CPM) is used by many authors. 5,8,9,51,52,125,132,134,135,142,203,204 However, there have been only 2 studies that investigated the role of CPM in the postoperative management of operative elbow release, one of these presumably being an Figure 5. Transverse section of a normal elbow before and after distention.…”

“…177 Most authors start mobilization of the elbow within 2 days after an open contracture release, 8,51,52,64,65,125,126,128,133,134,137,202 which may be enhanced by sufficient pain control. 8,125,127,132,202,203 Continuous passive motion (CPM) is used by many authors.…”

“…18 The most common complications of open contracture release include neuropathies, infection, and recurrence of elbow stiffness and/or heterotopic bone. 1,8,12,19,20,52,53,125,127,128,132,134,135,137,138,142 Lateral column procedure. 159 Either a lateral or midline posterior incision is used, fasciocutaneous flaps are elevated and started proximally, and the lateral supracondylar ridge of the humerus is exposed by reflecting the extensor carpi radialis longus (ECRL) anteriorly off the humerus and the triceps off the humerus posteriorly.…”

The outcome of examination (manipulation) under anesthesia on the stiff elbow after surgical contracture release

“…Various operative techniques have been described, with improved arc reported in approximately 90% of patients. 1,2,3,6,9,11,14 Various postoperative rehabilitation protocols are used, including indwelling axillary catheters and continuous passive motion, continuous passive motion at home, static and dynamic splinting, and manipulation under anesthesia. The role of manipulation under anesthesia in the stiff elbow has remained unclear, with little objective information about the technique.…”