Open Elbow Arthrolysis for Posttraumatic Elbow Stiffness

Cikes, Alec; Jolles, Brigitte M.; Farron, Alain

doi:10.1097/00005131-200607000-00007

Cited by 73 publications

(36 citation statements)

References 6 publications

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“…34 Patients can expect the final ROM achieved at 1 year to be maintained for up to 10 years. 2,15,17,30,31,[36][37][38] Greater improvement in ROM and higher satisfaction can be expected in patients with more severe contractures and after resection of heterotopic ossification. 2,15,17,30,31,[36][37][38] Greater improvement in ROM and higher satisfaction can be expected in patients with more severe contractures and after resection of heterotopic ossification.…”

Section: Resultsmentioning

confidence: 99%

“…35 A history of prior surgery has not been shown to affect the final outcome. 31,37,39,40 Although children and adolescent patients with extra-articular elbow contracture release commonly achieve similar outcomes as adults, as a group, patients between the ages of 10 and 20 years have less predictable outcomes than do older individuals. 31,37,39,40 Although children and adolescent patients with extra-articular elbow contracture release commonly achieve similar outcomes as adults, as a group, patients between the ages of 10 and 20 years have less predictable outcomes than do older individuals.…”

Section: Resultsmentioning

confidence: 99%

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Open Surgical Release for Contractures of the Elbow

Streubel¹,

Cohen²

2015

Journal of the American Academy of Orthopaedic Surgeons

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Compared with arthroscopic release, open release is more commonly used for the treatment of stiff elbow. Flexion is recovered by releasing posterior tethering soft-tissue structures and by removing anterior impingement between the coronoid and/or radial head and the distal humerus. Extension is improved by releasing anterior soft-tissue tethers and by removing impingement between the olecranon tip and the olecranon fossa. Open elbow release is most commonly performed via ligament-sparing approaches. Ulnar nerve identification and transposition is recommended in the presence of nerve dysfunction or when correction of significant loss of elbow flexion is anticipated. Long-term improvement in flexion and extension can be expected with proper patient selection. Less predictable results are obtained in adolescent patients and in those with underlying traumatic brain injury.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Open Surgical Release for Contractures of the Elbow

Streubel¹,

Cohen²

2015

Journal of the American Academy of Orthopaedic Surgeons

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“…22 The mean improvement in ROM of 40° was comparable to that in previously reported studies. 13,20,21,[23][24][25] Nine patients who had a pre-operative ROM of < 30° achieved the greatest improvement, with a final mean flexion arc of 92°. This counterintuitive finding, first identified by Morrey in his classic paper in 1990, 9 has also been reported in other series.…”

Section: Discussionmentioning

confidence: 97%

“…This counterintuitive finding, first identified by Morrey in his classic paper in 1990, 9 has also been reported in other series. 6,24 However, the reasons for the finding remain unclear. Two patients had no improvement in the ROM with no obvious reason for the failure of treatment.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of open arthrolysis of the elbow without post-operative passive stretching

Higgs

Danks

Sibiński

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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The use of passive stretching of the elbow after arthrolysis is controversial. We report the results of open arthrolysis in 81 patients. Prospectively collected outcome data with a minimum follow-up of one year were analysed. All patients had sustained an intra-articular fracture initially and all procedures were performed by the same surgeon under continuous brachial plexus block anaesthesia and with continuous passive movement (CPM) used post-operatively for two to three days. CPM was used to maintain the movement achieved during surgery and passive stretching was not used at any time. A senior physiotherapist assessed all the patients at regular intervals. The mean range of movement (ROM) improved from 69° to 109° and the function and pain of the upper limb improved from 32 to 16 and from 20 to 10, as assessed by the Disabilities of the Arm Shoulder and Hand score and a visual analogue scale, respectively. The greatest improvement was obtained in the stiffest elbows: nine patients with a pre-operative ROM < 30° achieved a mean post-operative ROM of 92° (55° to 125°). This study demonstrates that in patients with a stiff elbow after injury, good results may be obtained after open elbow arthrolysis without using passive stretching during rehabilitation.

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“…The restriction in the degree of elbow flexion or rotation hinders the execution of daily activities. Surgical treatment of elbow stiffness has proved to be effective in restoring elbow motion [3][4][5], which significantly improves the patients' quality of life, particularly when post traumatic elbow function is low [6].…”

Section: Introductionmentioning

confidence: 99%