Open elbow arthrolysis for post-traumatic elbow stiffness

Abstract

Post-traumatic elbow stiffness is a disabling condition that remains challenging for upper limb surgeons. Open elbow arthrolysis is commonly used for the treatment of stiff elbow when conservative therapy has failed. Multiple questions commonly arise from surgeons who deal with this disease. These include whether the patient has post-traumatic stiff elbow, how to evaluate the problem, when surgery is appropriate, how to perform an excellent arthrolysis, what the optimal postoperative rehabilitation is, and how to prevent or reduce the incidence of complications. Following these questions, this review provides an update and overview of post-traumatic elbow stiffness with respect to the diagnosis, preoperative evaluation, arthrolysis strategies, postoperative rehabilitation, and prevention of complications, aiming to provide a complete diagnosis and treatment path. Cite this article: Bone Joint Open 2020;1-9:576–584.

Development and validation of a prognostic nomogram for open elbow arthrolysis

“…This is consistent with our experience and previous research, as the pathological characteristics and strategies for arthrolysis are basically similar for the management of post-traumatic stiffness of the elbow. 21,22 Our findings have several clinical implications. First, the efficacy of surgery could be improved by addressing risk factors preoperatively, such as losing weight and shortening the time between the initial injury and arthrolysis.…”

“…This is consistent with our experience and previous research, as the pathological characteristics and strategies for arthrolysis are basically similar for the management of post-traumatic stiffness of the elbow. 21 , 22 …”

“…Our indications and detailed surgical techniques for the open elbow arthrolysis have been extensively reported. 9,[20][21][22] the lateral (along the lateral column) and medial-posterior (posterior to the medial epicondyle) incisions are used, unless the patient has a previous posterior incision.…”

“…BMI was classified according to the Chinese BMI criteria of the Working Group on Obesity in China. 25 ROM was measured using a goniometer, as previously described, 21 with three landmarks (lateral epicondyle, tip of the acromion, and middle portion of wrist). 26 The intensity of pain was evaluated using a visual analogue scale (VAS, 0 = no pain, 10 = very severe pain).…”

What are the prevalence of and factors independently associated with depression and anxiety among patients with posttraumatic elbow stiffness? A cross-sectional, multicenter study

“…Information was obtained from the medical records, including dominant and affected limb side, disease duration (length of time with stiff elbow), initial injury type (simple fracture or dislocation/ complex fracture or dislocation), treatment history, elbow ROM, elbow pain intensity at rest and on movement, ulnar neuropathy, and HO around the elbow. ROM was measured by a goniometer, as described in the previous study, 34 with 3 landmarks (lateral epicondyle, tip of acromion process, and middle portion of the wrist). 3 Pain intensity was evaluated by visual analog scale (0 ¼ no pain, 10 ¼ very severe pain).…”