The contracted elbow: is ulnar nerve release necessary?

Williams, Benjamin G.; Sotereanos, Dean G.; Baratz, Mark E.; Jarrett, Claudius D.; Venouziou, Aaron I.; Miller, Mark Carl

doi:10.1016/j.jse.2012.04.007

Cited by 52 publications

(29 citation statements)

References 26 publications

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“…It should address the pathology causing stiffness, severity of contracture, presence and location of heterotopic ossification, previous scars from past operations and ulnar neuropathy [12, 21]. In cases where the preoperative flexion is less than 100° some authors suggest that ulnar nerve decompression may be indicated [14, 22]. …”

Section: Discussionmentioning

confidence: 99%

The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases

Bręborowicz

Lubiatowski

Długosz

et al. 2013

International Orthopaedics (SICOT)

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PurposeThe aim of this study was to evaluate the results of elbow arthrolysis according to the surgical approach, durability after arthrolysis and the severity of contracture.MethodsThe study includes a cohort of 100 consecutive patients treated in our institution between 1986 and 2008. The indication for surgery was loss of mobility. This was the result of fractures, dislocation, simultaneous fracture/dislocation or other non-traumatic causes. All patients underwent open elbow release via one of four approaches (42 lateral, 44 medial, six combined medial-lateral and eight posterior). They were clinically evaluated at a minimum of 24 months after arthrolysis.ResultsThe average ranges of elbow extension, flexion and arc of motion had increased significantly at the follow up, respectively, by 20°, 16° and 36°. No significant difference was found with regard to surgical approach. However, we noticed significant deterioration of intra-operative average extension and arc of motion (AOM) over the follow up period, respectively, by 13° and 14°. The number of patients with AOM of 100° or more increased from three patients preoperatively to 28 postoperatively.ConclusionsOpen elbow arthrolysis is a successful method of treatment of elbow contracture. Results are durable, but there is some postoperative deterioration of extension gained during surgery. We may anticipate that at the final stage we shall obtain an average of 86 % of intra-operative arc of motion. Patients with the most severe contractures have the best gains.

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Section: Discussionmentioning

confidence: 99%

The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases

Bręborowicz

Lubiatowski

Długosz

et al. 2013

International Orthopaedics (SICOT)

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“…Darüber hinaus ist eine präoperative Diagnostik des N. ulnaris unabdingbar. Eine Neurolyse ist vor der Arthrolyse bei Ellenbogensteifen empfohlen, bei denen eine Limitierung der Flexion auf <90-100°und Limitierung der Extension auf >60°vorliegt, da es sonst zu Traktionsschäden des N. ulnaris kommen kann [3,25]. Andere Autoren empfehlen die routinemäßige Neurolyse des N. ulnaris [13].…”

Section: Offene Arthrolyseunclassified

Steifer posttraumatischer Ellenbogen

Rausch

Glinski

Königshausen

et al. 2017

Trauma Berufskrankh

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“…Although there is no agreement on the superiority of the radial head replacement over simple excision [13], we always replaced the radial head with a prosthesis (KPS) designed by the senior author. Release of the ulnar nerve was consistently combined with its anterior transposition and was never performed prophylactically despite recent reports underlining its benefit [14][15][16]. Arthrolysis of the elbow can be performed using other approaches, most often Kocher approach, as well as combined with exposing the joint from the medial or posterior aspect [17][18][19][20] depending on the underlying pathology [21].…”

Section: Introductionmentioning

confidence: 99%

The column procedure preserves elbow stability on biomechanical testing

Podgórski

Kordasiewicz

Pomianowski

2020

International Orthopaedics (SICOT)

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The effect of open release of a post-traumatic elbow contracture on the stability of the joint has not been so far studied in vivo. Resection of elbow joint capsule, the key element of surgery, was reported to have no effect on the stability of cadaveric elbows. The joint capsule is yet known to participate in maintaining elbow stability as one of secondary stabilizers. Methods We assessed elbow joint laxity in 39 patients who underwent an open contracture release via the 'column procedure' described by B. Morrey and P. Mansat within the preceeding three to nine months. The measurements were taken with an apparatus designed particularly for this experiment according to the predetermined protocol. A preliminary part of the experiment showed that there was no significant difference between laxity of two elbow joints in healthy volunteers. Laxity of the operated elbows could be then compared with the contralateral joints. Results Mean absolute difference of laxity between healthy and operated elbows was 1.55°(0.1°-4.1°, SD = 1.1) being significantly lower than 2°, p = 0.0056. The difference of the joint laxity between the operated and healthy elbows did not differ statistically significantly by more than 0.6°from the difference of the laxity of two healthy elbows and, therefore, is not clinically noticeable. Conclusions Our experiment confirmed that the 'column procedure' is a safe procedure which does not compromise the stability of the elbow joint.

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The contracted elbow: is ulnar nerve release necessary?

Cited by 52 publications

References 26 publications

The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases

The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases

Steifer posttraumatischer Ellenbogen

The column procedure preserves elbow stability on biomechanical testing

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