The relation between elbow range of motion and patient satisfaction after open release of stiff elbow

Abstract

ObjectiveThe aim of this retrospective study was to find out whether a cut off value existed for elbow flexion and extension after open surgical release of elbow contracture that would correlate with subjective patient satisfaction.MethodsThe study enrolled 77 patients (53 males and 24 females with a mean age of 35.1 (18–77) years at the time of operation) with elbow contracture who attended regular follow-up appointments for more than 12 months. The mean follow up period was 44.2 months (12–186). The preoperative and postoperative modified MAYO elbow scores, objective parameters of increase in both flexion and extension end point measurements and improvement in total ROM were compared in order to determine the cut off degree of ROM in both flexion and extension that significantly correlated with patient satisfaction.ResultsOf the 77 participating patients, 26 patients had an extrinsic (33.8%) and 51 patients had an intrinsic elbow contracture (66.2%). Surgeries performed involved 40 cases of lateral release and 37 cases of both lateral and medial (progressive) release. The median preoperative total flexion-extension arch (ROM) was 45° (20°–65°). The median postoperative total flexion-extension arch (ROM) was 110° (97.5°–125°). The modified MAYO elbow score improved from 60 to 85 points postoperatively. The postoperative flexion cut off value was 115° for an excellent or good postoperative modified MAYO elbow score.ConclusionPost-operative flexion cut off value was 115° and had a positive effect on the postoperative patient satisfaction. The cut off value for postoperative extension was 20° but it was not a significant variable on patient satisfaction as was the total increase in ROM.Level of significanceLevel IV Therapeutic Study.

Functional elbow range of motion 6 months after contracture release and ORIF K-wire in elbow stiffness with malunion capitellum and neglected radial head and ulnar dislocation: a case report

“…[1,7] A study by Morrey et al in 1981, showed that people could perform daily activity if the ROM of the elbow was at least 30 0 - 130 0 in flexion-extension, and 50 0 in pronation and supination. Loss of extension greater than 30 0 and flexion less than 120 0 is classified as elbow stiffness [3]. Hotchkiss classify elbow stiffness in three categories: minimal, moderate, and severe (Table 1) [8].…”

“…Unfortunately, elbow is prone to trauma, and it is susceptible of developing complications such as stiffness and degeneration [1]. Abnormalities of the bone, soft tissue, or combination of both, which may be intra-articular or extra-articular, can cause loss of elbow motion [2,3]. Morrey et al stated that elbow functional range of motion (ROM) for daily activity are 30 0 - 130° of flexion-extension and 50° of pronation-supination in either direction [1].…”

Plate-and-bone-strut fixation of distal third humeral shaft aseptic non-unions: A consecutive case series

“…To diminish bias because of different rehabilitation, we let all patients undergo the same rehabilitation protocol (see appendix). The objective outcomes during follow-up were surgical data, adverse events during follow-up, range of motion, the Mayo Elbow Score (MES) 8 and humeral alignment measured using plain radiographs. Subjective patient reported outcomes were measured by Oxford Elbow Score (OES) 9 .…”

Fracture-pattern-related therapy concepts in distal humeral fractures

“…In general, the elbow is characterized by a small intracapsular volume, leading to effusion, scarring, hemarthrosis, and ultimately thickening of the capsule. Owing to these anatomical characteristics, stiff elbow is a common occurrence after trauma [ 26 ].…”