Limited Medial and Lateral Approaches to Treat Stiff Elbows

Wang, Wei; Liu, Shen; Jiang, Shi; Ruan, Hong jiang; He, Ning; Fan, Cun Yi

doi:10.3928/01477447-20150603-55

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…The implications of Table 4 require caution as all but one study that used a hinged external fixator in addition to the open procedure was performed at the same medical center where apparently a hinged external fixator is used as a standard procedure. [ 20 , 23 , 25 – 27 , 30 , 32 ]…”

Section: Discussionmentioning

confidence: 99%

Surgical arthrolysis of the stiff elbow: a systematic review

Lanzerath

Wegmann

Hackl

et al. 2022

Arch Orthop Trauma Surg

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Introduction Stiffness after elbow injuries can severely limit daily life. If adequate conservative treatment does not result in satisfactory improvement of elbow function, surgical intervention should be considered. Whether an open or arthroscopic procedure is preferable is still a topic of debate and a systematic review of functional outcomes is lacking. Materials and methods We systematically reviewed the available literature searching electronic databases, MEDLINE using the PubMed interface and EMBASE, for studies published between 2013 and 2021. Primary objective was to compare open and arthroscopic arthrolysis’ functional outcomes, respectively, especially ROM and MEPS, as well as the accompanied complications. The PRISMA guidelines were applied. Results 27 studies comprising 1666 patients were included. 1059 patients (63.6%) were treated with open arthrolysis, and 607 patients (36.4%) were treated with arthroscopic arthrolysis. The results presented indicate satisfactory outcomes in open and arthroscopic arthrolysis with regard to functional outcome parameters. Treatment success, defined as excellent or good results according to the Mayo Elbow Performance Score, among the patients treated with an open procedure was 88.8%; 6.3% required revision whereas 18.1% had complications without the need for revision surgery. Within the cohort of arthroscopically treated patients, treatment success was 91.8%. Revisions and complications without further surgical intervention were significantly less frequent than in the open cohort, at 1.6% and 9.1%, respectively. Conclusions Both open and arthroscopic arthrolysis provide good to excellent functional outcomes. Since the number of complications and revision increases with the invasiveness of the treatment, an arthroscopic procedure might be favored if feasible by indication. The role of forearm rotation and the use of a hinged external fixator remains of interest. Study design Level IV; Systematic review.

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Section: Discussionmentioning

confidence: 99%

Surgical arthrolysis of the stiff elbow: a systematic review

Lanzerath

Wegmann

Hackl

et al. 2022

Arch Orthop Trauma Surg

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“…In order to avoid instability after arthrolysis, some surgeons use the technique of hinged external fixation. Zhou et al [35] In all these studies, the hinged external fixation provided stability for the elbow immediately after the surgery, which allowed safe and early exercise [38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of the Functional Outcomes of Combined Medial-lateral Approach Arthrolysis With or Without External Fixation for Severe Elbow Stiffness

Xiao

Gong

Chen

et al. 2021

Preprint

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Background: To evaluate and compare the functional outcomes of combined medial-lateral approach open arthrolysis with and without hinged external fixation. Methods: We retrospectively collected and analysed the clinical data of patients with severe elbow stiffness who were treated in our center from January 2018 to January 2019. All of them were treated with combined medial-lateral approach arthrolysis. There were 20 patients who had the hinged external fixation placed and 29 patients without the placement of the external fixation. Their baseline characteristics and functional outcomes were evaluated and compared. Results: The average follow-up time was 28.4±3.7 months. There were no significant differences in the ROM of the elbow, MEPS, VAS, DASH, or complications between the two groups. The operation time and cost of the patients without external fixation were significantly lower than patients with external fixation. Conclusion: Combined medial-lateral approach open elbow arthrolysis without external fixation is a safe and effective way to treat elbow stiffness. Level of Evidence: Therapeutic Level III; Retrospective Cohort Comparison; Treatment Study.

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“…The flexion-extension range improved by 102.4°, and the average MEPS increased by 44. In all these studies, the hinged external fixation provided stability for the elbow immediately after the surgery, which allowed safe and early exercise [ 38 – 40 ].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of the functional outcomes of combined medial-lateral approach arthrolysis with or without external fixation for severe elbow stiffness

Xiao

Gong

Chen

et al. 2021

BMC Musculoskelet Disord

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Background To evaluate and compare the functional outcomes of combined medial-lateral approach open arthrolysis with and without hinged external fixation. Methods We retrospectively collected and analyzed the clinical data of patients with severe elbow stiffness who were treated in our institution from January 2018 to January 2019. All of them were treated with combined medial-lateral approach arthrolysis. There were 20 patients who had the hinged external fixation placed and 29 patients without the placement of the external fixation. Their baseline characteristics and functional outcomes were evaluated and compared. Results The average follow-up time was 28.4 ± 3.7 months. There were no significant differences in the ROM of the elbow, MEPS, VAS, DASH, or complications between the two groups. The operation time and treatment cost of the patients without external fixation were significantly lower than patients with external fixation. Conclusion Combined medial-lateral approach open elbow arthrolysis without external fixation is a safe and effective way to treat elbow stiffness. Level of evidence Therapeutic Level III; Retrospective Cohort Comparison; Treatment Study.

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Limited Medial and Lateral Approaches to Treat Stiff Elbows

Cited by 7 publications

References 31 publications

Surgical arthrolysis of the stiff elbow: a systematic review

Surgical arthrolysis of the stiff elbow: a systematic review

Comparative Study of the Functional Outcomes of Combined Medial-lateral Approach Arthrolysis With or Without External Fixation for Severe Elbow Stiffness

Comparative study of the functional outcomes of combined medial-lateral approach arthrolysis with or without external fixation for severe elbow stiffness

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