Validation of the Liverpool Elbow Score for evaluation of elbow stiffness

Sun, Ziyang; Fan, Cunyi

doi:10.1186/s12891-018-2226-0

Cited by 5 publications

(3 citation statements)

References 41 publications

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“…Such degradation of the articular cartilage would contribute to secondary joint arthrosis, which in turn, will further aggravate elbow stiffness, pain, and instability. Additionally, a long-term stiffness of the elbow would significantly inconvenience patients in their daily activities and has a great negative impact on the quality of life [ 34 , 35 ]. Most patients would want to resolve this issue as early as possible.…”

Section: Discussionmentioning

confidence: 99%

Determining the effective timing of an open arthrolysis for post-traumatic elbow stiffness: a retrospective cohort study

Sun

Cui

Liang

et al. 2019

BMC Musculoskelet Disord

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BackgroundFollowing trauma, the elbow is the most susceptible to restricted motion among all joints. Open arthrolysis is often performed for post-traumatic elbow stiffness if that stiffness does not improve with non-operative management. However, the optimal timing for performing an open arthrolysis remains controversial. The purpose of this study was to compare the outcome (elbow motion and function) and the rate of complications among patients who had undergone early, median and late release procedures to establish an optimal time interval following the injury, after which, an effective open arthrolysis can be performed.MethodsIn this retrospective cohort study, we included total 133 patients, who had undergone open arthrolysis for post-traumatic elbow stiffness. The subjects were divided into 3 groups, with 31 patients in the early release group (arthrolysis performed at 6–10 months after injury), 78 patients in the median release group (at 11–20 months), and 24 patients in the late release group (at > 20 months). The release procedure in all patients was performed by the same surgeon, using the same technique. The general data, functional performance, and complications, if any, were retrospectively documented for all patients and statistically analysed.ResultsThe demographic data and disease characteristics of all patients were comparable at baseline. Postoperatively, no significant differences were found among the three groups with respect to the range of motion (p = 0.067), Mayo Elbow Performance Score (p = 0.350) and its ratings (p = 0.329), visual analog scale score for pain (p = 0.227), Dellon classification for ulnar nerve symptoms (p = 0.497), and each discrete complication (all p values > 0.05).ConclusionsAt the final follow-up, our results showed no significant difference in the postoperative elbow motion capacities, functional scores and the rates of complications among patients who had undergone an early, median, and late release. Therefore, we have recommended that an early arthrolysis would be preferable due to its multiple advantages, and the conventionally observed interval of > 1 year after the injury, could be shortened.Level of evidenceLevel III; Retrospective Cohort Design; Therapeutic Study.

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Section: Discussionmentioning

confidence: 99%

Determining the effective timing of an open arthrolysis for post-traumatic elbow stiffness: a retrospective cohort study

Sun

Cui

Liang

et al. 2019

BMC Musculoskelet Disord

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“…6 The Liverpool Elbow Score (LES) has also recently been validated to evaluate the functionality of the joint in patients with rigid elbow. 18 …”

Section: Classificationsmentioning

confidence: 99%

The stiff elbow: Current concepts

Masci¹,

Cazzato²,

Milano³

et al. 2020

Orthop Rev (Pavia)

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Elbow stiffness is defined as any loss of movement that is greater than 30° in extension and less than 120° in flexion. Causes of elbow stiffness can be classified as traumatic or atraumatic and as congenital or acquired. Any alteration affecting the stability elements of the elbow can lead to a reduction in the arc of movement. The classification is based on the specific structures involved (Kay’s classification), anatomical location (Morrey’s classification), or on the degree of severity of rigidity (Vidal’s classification). Diagnosis is the result of a combination of medical history, physical examination (evaluating both active and passive movements), and imaging. The loss of soft tissue elasticity could be the result of bleeding, edema, granulation tissue formation, and fibrosis. Preventive measures include immobilization in extension, use of post-surgical drain, elastic compression bandage and continuous passive motion. Conservative treatment is used when elbow stiffness has been present for less than six months and consists of the use of serial casts, static or dynamic splints, CPM, physical therapy, manipulations and functional re-education. If conservative treatment fails or is not indicated, surgery is performed. Extrinsic rigidity cases are usually managed with an open or arthroscopic release, while those that are due to intrinsic causes can be managed with arthroplasties. The elbow is a joint that is particularly prone to developing stiffness due to its anatomical and biomechanical complexity, therefore the treatment of this pathology represents a challenge for the physiotherapist and the surgeon alike.

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“…ASES-E score showed that the patient measured her pain around 5-6 (Range 1-10; 0= no pain/ 10= worst pain ever) and her subjective function of her right elbow has been graded between 0-1 (unable to do/very difficult to do the activities listed in the questionnaire). The choice of using these two surveys has been taken because there is no score considered gold standard, ASES-E is organ specific and has multiple criteria, and LES is fast to do and has good reproducibility [14], [22].…”

Section: Case Reportmentioning

confidence: 99%

Hyperextension Malunion of the Distal Humerus - Chevron Osteotomy: A Case Report

Necula

Balogh-Ungureanu

2020

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"Treatment of hyperextension malunions of the distal humerus is done by osteotomy, several types being described in the literature. The aim of the paper is to highlight the possibility of using Chevron-type osteotomy in sagittal malunions of the distal humerus shaft. The patient presented in this case report has suffered multiple interventions after a 13C1 AO/OTA fracture of her right arm. When the malunion was identified her range of motion (ROM) was 40-90 degrees flexion. We have performed a supracondylar sagittal Chevron osteotomy at a 30 degrees angle open anteriorly. After the surgery, her ROM improved to 40-135 degrees flexion. The authors chose the Chevron osteotomy because it created an increased area (by 30%) of the interface between the two fragments and offers a good rotational stability. Unfortunately, information in the literature is limited and future studies must be done to endorse the usage of Chevron osteotomy in hyperextension malunion of the distal humerus."

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Validation of the Liverpool Elbow Score for evaluation of elbow stiffness

Cited by 5 publications

References 41 publications

Determining the effective timing of an open arthrolysis for post-traumatic elbow stiffness: a retrospective cohort study

Determining the effective timing of an open arthrolysis for post-traumatic elbow stiffness: a retrospective cohort study

The stiff elbow: Current concepts

Hyperextension Malunion of the Distal Humerus - Chevron Osteotomy: A Case Report

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