Research Article
Year 2023,
, 141 - 146, 17.03.2023
Abstract
References
- Morrey BF, Askew LJ and Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63:872-7.
- Adolfsson L. Post-traumatic stiff elbow. EFORT Open Rev. 2018;3:210-6. DOI:10.1302/2058-5241.3.170062
- Haglin JM, Kugelman DN, Christiano A, et al. Open surgical elbow contracture release after trauma: results and recommendations. J Shoulder Elbow Surg. 2018;27:418-26. DOI:10.1016/j.jse.2017.10.023
- Morrey BF. Post-traumatic contracture of the elbow. Operative treatment, including distraction arthroplasty. J Bone Joint Surg Am. 1990;72:601-18.
- Doornberg JN, Ring D and Jupiter JB. Static progressive splinting for posttraumatic elbow stiffness. J Orthop Trauma. 2006;20:400-4. DOI:10.1097/00005131-200607000-00006
- Muller AM, Sadoghi P, Lucas R, et al. Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies. J Shoulder Elbow Surg. 2013;22:1146-52. DOI:10.1016/j.jse.2013.04.003
- Mansat P and Morrey BF. The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am. 1998;80:1603-15.
- Tucker SA, Savoie FH, 3rd and O'brien MJ. Arthroscopic management of the post-traumatic stiff elbow. J Shoulder Elbow Surg. 2011;20:S83-9. DOI:10.1016/j.jse.2010.11.029
- Marti RK, Kerkhoffs GM, Maas M, et al. Progressive surgical release of a posttraumatic stiff elbow. Technique and outcome after 2-18 years in 46 patients. Acta Orthop Scand. 2002;73:144-50. DOI:10.1080/000164702753671713
- Kapıcıoğlu M SY, Erşen a, Atalar a, Demirhan M,Durmaz H. Does Resection of Heterotopic Ossification of the Elbow Result in Satisfactory Functional Outcomes? Bezmiâlem Science. 2019;7:124-31. DOI:10.14235/bas.galenos.2018.2467
- Larson AN and Morrey BF. Interposition arthroplasty with an Achilles tendon allograft as a salvage procedure for the elbow. J Bone Joint Surg Am. 2008;90:2714-23. DOI:10.2106/JBJS.G.00768
- Mansat P and Morrey BF. Semiconstrained total elbow arthroplasty for ankylosed and stiff elbows. J Bone Joint Surg Am. 2000;82:1260-8. DOI:10.2106/00004623-200009000-00006
- Streubel PN and Cohen MS. Open surgical release for contractures of the elbow. J Am Acad Orthop Surg. 2015;23:328-38. DOI:10.5435/JAAOS-D-14-00051
- Wada T, Ishii S, Usui M, et al. The medial approach for operative release of post-traumatic contracture of the elbow. J Bone Joint Surg Br. 2000;82:68-73. DOI:10.1302/0301-620x.82b1.9782
- Park MJ, Kim HG and Lee JY. Surgical treatment of post-traumatic stiffness of the elbow. J Bone Joint Surg Br. 2004;86:1158-62. DOI:10.1302/0301-620x.86b8.14962
- Tan V, Daluiski A, Simic P, et al. Outcome of open release for post-traumatic elbow stiffness. J Trauma. 2006;61:673-8. DOI:10.1097/01.ta.0000196000.96056.51
- Ring D, Adey L, Zurakowski D, et al. Elbow capsulectomy for posttraumatic elbow stiffness. J Hand Surg Am. 2006;31:1264-71. DOI:10.1016/j.jhsa.2006.06.009
- Gundlach U and Eygendaal D. Surgical treatment of posttraumatic stiffness of the elbow: 2-year outcome in 21 patients after a column procedure. Acta Orthop. 2008;79:74-7. DOI:10.1080/17453670710014798
- Higgs ZC, Danks BA, Sibinski M, et al. Outcomes of open arthrolysis of the elbow without post-operative passive stretching. J Bone Joint Surg Br. 2012;94:348-52. DOI:10.1302/0301-620X.94B3.27278
- Pettersen PM, Eriksson J, Bratberg H, et al. Increased ROM and high patient satisfaction after open arthrolysis: a follow-up-study of 43 patients with posttraumatic stiff elbows. BMC Musculoskelet Disord. 2016;17:74. DOI:10.1186/s12891-016-0928-8
- Zhang D, Nazarian A and Rodriguez EK. Post-traumatic elbow stiffness: Pathogenesis and current treatments. Shoulder Elbow. 2020;12:38-45. DOI:10.1177/1758573218793903
- Blonna D and O'driscoll SW. Delayed-onset ulnar neuritis after release of elbow contracture: preventive strategies derived from a study of 563 cases. Arthroscopy. 2014;30:947-56. DOI:10.1016/j.arthro.2014.03.022
- Shuai C, Hede Y, Shen L, et al. Is routine ulnar nerve transposition necessary in open release of stiff elbows? Our experience and a literature review. Int Orthop. 2014;38:2289-94. DOI:10.1007/s00264-014-2465-0
- Williams BG, Sotereanos DG, Baratz ME, et al. The contracted elbow: is ulnar nerve release necessary? J Shoulder Elbow Surg. 2012;21:1632-6. DOI:10.1016/j.jse.2012.04.007
Year 2023,
, 141 - 146, 17.03.2023
Abstract
Purpose
Stiff elbow is a common upper extremity problem which can limit patients’ daily life activities. The purpose of this study was to evaluate the long-term outcomes of open arthrolysis for stiff elbow. Our hypothesis was that open arthrolysis would yield good functional results and patient satisfaction.
Methods
This retrospective study assessed 110 patients who underwent surgery for stiff elbow in a single institute between 2003-2012. Twenty-four of the patients who underwent open arthrolysis without heterotopic ossification excision and minimum followed up for 24 months were included in this study. All patient’s surgical procedure, ulnar nerve and radial head management, preoperative and postoperative ranges of elbow motion and complications were noted. Functional outcomes were evaluated with Quick-DASH and Mayo Elbow Performance score (MEPS).
Results
The mean age of the patients was 36.1 years at the time of open arthrolysis and mean follow-up period was 50.6 months. The mean preoperative flexion–extension arc increased form 52.4 to 96.5 and preoperative supination–pronation arc increased form 103.3 to 137.8 (p<0.05). The mean MEPS score was 81.6 and the Q-DASH score was 6.3. Complication occurred in 9 patients (37.5%) and 4 patients required additional surgery.
Conclusion
Open arthrolysis is an effective treatment method for stiff elbows, with reliable long-term functional outcomes. The complication rates are high; however, they are generally minor and temporary.
Keywords
References
- Morrey BF, Askew LJ and Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63:872-7.
- Adolfsson L. Post-traumatic stiff elbow. EFORT Open Rev. 2018;3:210-6. DOI:10.1302/2058-5241.3.170062
- Haglin JM, Kugelman DN, Christiano A, et al. Open surgical elbow contracture release after trauma: results and recommendations. J Shoulder Elbow Surg. 2018;27:418-26. DOI:10.1016/j.jse.2017.10.023
- Morrey BF. Post-traumatic contracture of the elbow. Operative treatment, including distraction arthroplasty. J Bone Joint Surg Am. 1990;72:601-18.
- Doornberg JN, Ring D and Jupiter JB. Static progressive splinting for posttraumatic elbow stiffness. J Orthop Trauma. 2006;20:400-4. DOI:10.1097/00005131-200607000-00006
- Muller AM, Sadoghi P, Lucas R, et al. Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies. J Shoulder Elbow Surg. 2013;22:1146-52. DOI:10.1016/j.jse.2013.04.003
- Mansat P and Morrey BF. The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am. 1998;80:1603-15.
- Tucker SA, Savoie FH, 3rd and O'brien MJ. Arthroscopic management of the post-traumatic stiff elbow. J Shoulder Elbow Surg. 2011;20:S83-9. DOI:10.1016/j.jse.2010.11.029
- Marti RK, Kerkhoffs GM, Maas M, et al. Progressive surgical release of a posttraumatic stiff elbow. Technique and outcome after 2-18 years in 46 patients. Acta Orthop Scand. 2002;73:144-50. DOI:10.1080/000164702753671713
- Kapıcıoğlu M SY, Erşen a, Atalar a, Demirhan M,Durmaz H. Does Resection of Heterotopic Ossification of the Elbow Result in Satisfactory Functional Outcomes? Bezmiâlem Science. 2019;7:124-31. DOI:10.14235/bas.galenos.2018.2467
- Larson AN and Morrey BF. Interposition arthroplasty with an Achilles tendon allograft as a salvage procedure for the elbow. J Bone Joint Surg Am. 2008;90:2714-23. DOI:10.2106/JBJS.G.00768
- Mansat P and Morrey BF. Semiconstrained total elbow arthroplasty for ankylosed and stiff elbows. J Bone Joint Surg Am. 2000;82:1260-8. DOI:10.2106/00004623-200009000-00006
- Streubel PN and Cohen MS. Open surgical release for contractures of the elbow. J Am Acad Orthop Surg. 2015;23:328-38. DOI:10.5435/JAAOS-D-14-00051
- Wada T, Ishii S, Usui M, et al. The medial approach for operative release of post-traumatic contracture of the elbow. J Bone Joint Surg Br. 2000;82:68-73. DOI:10.1302/0301-620x.82b1.9782
- Park MJ, Kim HG and Lee JY. Surgical treatment of post-traumatic stiffness of the elbow. J Bone Joint Surg Br. 2004;86:1158-62. DOI:10.1302/0301-620x.86b8.14962
- Tan V, Daluiski A, Simic P, et al. Outcome of open release for post-traumatic elbow stiffness. J Trauma. 2006;61:673-8. DOI:10.1097/01.ta.0000196000.96056.51
- Ring D, Adey L, Zurakowski D, et al. Elbow capsulectomy for posttraumatic elbow stiffness. J Hand Surg Am. 2006;31:1264-71. DOI:10.1016/j.jhsa.2006.06.009
- Gundlach U and Eygendaal D. Surgical treatment of posttraumatic stiffness of the elbow: 2-year outcome in 21 patients after a column procedure. Acta Orthop. 2008;79:74-7. DOI:10.1080/17453670710014798
- Higgs ZC, Danks BA, Sibinski M, et al. Outcomes of open arthrolysis of the elbow without post-operative passive stretching. J Bone Joint Surg Br. 2012;94:348-52. DOI:10.1302/0301-620X.94B3.27278
- Pettersen PM, Eriksson J, Bratberg H, et al. Increased ROM and high patient satisfaction after open arthrolysis: a follow-up-study of 43 patients with posttraumatic stiff elbows. BMC Musculoskelet Disord. 2016;17:74. DOI:10.1186/s12891-016-0928-8
- Zhang D, Nazarian A and Rodriguez EK. Post-traumatic elbow stiffness: Pathogenesis and current treatments. Shoulder Elbow. 2020;12:38-45. DOI:10.1177/1758573218793903
- Blonna D and O'driscoll SW. Delayed-onset ulnar neuritis after release of elbow contracture: preventive strategies derived from a study of 563 cases. Arthroscopy. 2014;30:947-56. DOI:10.1016/j.arthro.2014.03.022
- Shuai C, Hede Y, Shen L, et al. Is routine ulnar nerve transposition necessary in open release of stiff elbows? Our experience and a literature review. Int Orthop. 2014;38:2289-94. DOI:10.1007/s00264-014-2465-0
- Williams BG, Sotereanos DG, Baratz ME, et al. The contracted elbow: is ulnar nerve release necessary? J Shoulder Elbow Surg. 2012;21:1632-6. DOI:10.1016/j.jse.2012.04.007
There are 24 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthopaedics |
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 17, 2023 |
| Submission Date | December 11, 2022 |
| Published in Issue | Year 2023 |