The use of combined lateral and medial releases in the treatment of post-traumatic contracture of the elbow

Abstract

Elbow stiffness is a common disorder, which restricts daily activities. Between 30°and 130°of elbow movement is usually enough to perform most daily activities. However, a 10°to 15°loss of elbow extension may be a problem when the patient is an athlete. From 1996 to 2004, 20 elbows of 20 patients (who were available for follow-up examination) were treated by lateral and medial release at Kocaeli University, for post-traumatic elbow contracture. Preoperative and the postoperative 12-month follow-up measurements were performed. The mean preoperative arc of motion was 35°and this value improved to 86.2°. The maximum improvement at the arc of motion was 105°. In an effort to understand the pathophysiology of the condition, surgical approaches may be used safely. The purpose of this study was to assess the functional outcome of the elbow joint after using a combination of lateral and medial approaches to treat elbow stiffness. Résumé La raideur du coude est une pathologie fréquente qui restreint les activités quotidiennes. Pour celles-ci une

Management of severe extra-articular contracture of the elbow by open arthrolysis and a monolateral hinged external fixator

“…12,13,16,41,43 However, in our series there was no case of neuropathy, possibly because all patients underwent transposition of the ulnar nerve.…”

“…Anything less than the restoration of a functional range of movement represents a failure of treatment. Various protocols 12,13,17,[30][31][32] have been presented for the management of a stiff elbow, and this study aimed to combine the principles outlined in these protocols.…”

“…40 Various studies have reported progressive loss of movement in the post-operative period compared with the range achieved at operation. 3,12,41 We therefore aimed to achieve maximum intraoperative correction using a combined mediolateral approach to address the joint contracture from all sides, and perform an extensive radical release. As the collateral ligaments have been shown to be contracted and to limit correction of the deformity, 17 we advocate their sequential release.…”

The posttraumatic stiff elbow: an update

“…The medial aspect of the triceps is elevated to identify and excise the posterior capsule, release the posterior band of the medial collateral ligament, and remove osteophytes and heterotopic bone. Isolated medial approach has few indications, and it is most commonly used in addition to the lateral column procedure with satisfactory results [10,73,[75][76][77][78][79].…”

“…Continuous passive motion may improve elbow motion postoperatively [81,82]; however, its benefit in the postoperative management of elbow contracture release remains subject of discussion [115]. In addition, static progressive or dynamic splints can be used after contracture release to support the recovery of elbow motion [8,10,67,71,72,77,78,82].…”