Open Release and a Hinged External Fixator for the Treatment of Elbow Stiffness in Young Patients

Ouyang, Yuanming; Wang, Yongping; Li, Fengfeng; Fan, Cunyi

doi:10.3928/01477447-20120822-23

Cited by 14 publications

(4 citation statements)

References 23 publications

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“…12,13 A hinged external fixator (Stryker DJD II, Kalamazoo, MI, USA), was used in elbows in which both ligaments were reconstructed (two patients, Table 1). 14 The external fixator allowed full elbow flexion and extension and was removed in the OR at the sixth post-operative week. If the radial head had plastic deformity or malunion that blocked forearm rotation, it was excised or replaced (Tornier or Acumed, Hillsboro, OR, USA).…”

Section: Methodsmentioning

confidence: 99%

Open Surgical Release of Posttraumatic Elbow Contracture in Children and Adolescents

Piper

Lattanza

Shen

et al. 2019

Journal of Pediatric Orthopaedics

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Background: Post-traumatic elbow contractures in children and adolescents are challenging to manage, and studies investigating surgical treatment are limited by the rarity of this condition. Small case series have shown variable gains in immediate and long-term elbow arc of motion after open surgical release. We reviewed our experience with open surgical release of post-traumatic elbow contracture in patients less than 21 years old at two institutions. Methods: A retrospective chart review identified patients who underwent post-traumatic open elbow contracture release by two surgeons at two institutions between 2006 and 2013. Non-traumatic contractures and arthroscopic releases were excluded. 26 patients were included in this study. Mean age at the time of injury was 12 years (5–19 years) and at the time of surgery was 14 years (7–20 years). Capsulotomy, osteoplasty, removal of hardware, ulnar nerve release or transposition, and ligament reconstruction were performed through medial and lateral approaches as indicated by the pathology. 10 patients had ligament repair or stabilization, and 16 patients used a CPM post-operatively. Outcomes included active range of motion and complications. Results: Mean time from injury to surgical release was 29 months. Mean post-operative follow-up was 42 months. Elbow active flexion-extension and forearm rotation arcs both increased significantly by a mean of 49° and 70°, respectively, at final follow-up. A mean 85% of intra-operative flexion-extension arc was maintained at final follow-up. Ligament repair or reconstruction and the use of a postoperative CPM did not significantly change these outcomes. Outcomes were not significantly different if our contracture release was performed within a year from injury. Patients who had surgery prior to our contracture release had decreased restoration of forearm rotation after release. Complications included two recurrent contractures (one used a CPM and one did not), and two post-operative ulnar neuropathies (one used a CPM and one did not). Conclusions: Open contracture release for post-traumatic elbow contracture in an adolescent population can significantly improve active range of motion. Level of Evidence: Therapeutic 3

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Section: Methodsmentioning

confidence: 99%

Open Surgical Release of Posttraumatic Elbow Contracture in Children and Adolescents

Piper

Lattanza

Shen

et al. 2019

Journal of Pediatric Orthopaedics

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“…used the fixators after partial ligament release and obtained an improvement of 85°. 30 Wang et al . 31 released the ligament origins from humerus during the open arthrolysis.…”

Section: R Esultsmentioning

confidence: 99%

Posttraumatic stiff elbow

Mittal

2017

IJOO

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Posttraumatic stiff elbow is a frequent and disabling complication and poses serious challenges for its management. In this review forty studies were included to know about the magnitude of the problem, causes, pathology, prevention, and treatment of posttraumatic stiff elbow. These studies show that simple measures such as internal fixation, immobilization in extension, and early motion of elbow joint are the most important steps that can prevent elbow stiffness. It also supports conservative treatment in selected cases. There are no clear guidelines about the choice between the numerous procedures described in literature. However, this review article disproves two major beliefs-heterotopic ossification is a bad prognostic feature, and passive mobilization of elbow causes elbow stiffness.

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“…20,21 However, treatment of instability after a contracture has been released can be managed with hinged external fixation alone without ligament reconstruction. The need for stabilization of the elbow after contracture release should be anticipated preoperatively.…”

Section: Instabilitymentioning

confidence: 99%

Posttraumatic elbow contracture

Rafijah¹

2014

Current Orthopaedic Practice

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Posttraumatic elbow stiffness is a challenging problem that may follow elbow injury, especially in the setting of central nervous system injury or major burns. A multidisciplinary approach is required among patient, surgeon, therapist, and others for optimal treatment. Functional restoration of the elbow afflicted with a posttraumatic contracture is possible with both surgical and nonsurgical modalities. Prevention of elbow stiffness may yield the best results. OUTCOMES Overall, good results have been reported for open and arthroscopic contracture release of the elbow. Patients under-Current Orthopaedic Practice

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Open Release and a Hinged External Fixator for the Treatment of Elbow Stiffness in Young Patients

Cited by 14 publications

References 23 publications

Open Surgical Release of Posttraumatic Elbow Contracture in Children and Adolescents

Open Surgical Release of Posttraumatic Elbow Contracture in Children and Adolescents

Posttraumatic stiff elbow

Posttraumatic elbow contracture

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