Grading of functional results of elbow joint arthrolysis after fracture treatment.
In the treatment of posttraumatic contracture of the elbow joint, arthrolysis is a proven procedure. We used a stepwise operative approach starting laterally and including an additional medial and dorsal incision if needed. A total of 91 patients with arthrolysis of the elbow could be followed-up on average 44 months (range 9-102 months) joint after operative (58, 63.7%) and non-operative (33, 36.3%) fracture treatment. The mean preoperative range of motion (ROM) in flexion/extension was 49 degrees (SD +/- 38 degrees), while in pronation/supination it was 89 degrees (SD +/- 66 degrees). Postoperatively, the ROM was on average 94 degrees (SD +/- 27 degrees) in flexion/extension and 129 degrees (SD +/- 52 degrees) in pronation/supination. Using our own grading system, it became evident that most patients had a functional benefit from the procedure, although the quality of the improvement differed. For example, postoperatively 59.3% of the patients were grade I (> or = 90 degrees) in flexion/extension compared with 16.5% preoperatively. Although the rest also showed improvements, their functional benefit was less. The earlier the release of the joints was performed, the better was the functional outcome (p < 0.05). The importance of an intensive early rehabilitation programme is emphasised while indications for this procedure should only be seen in compliant patients.
Olivier
L C
LC
Department of Traumatology, University Clinic Essen, Germany. lucien.olivier@uni-essen.de
Assenmacher
S
S
Setareh
E
E
Schmit-Neuerburg
K P
KP
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003286:Contracture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003475:Curettage; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009011:Monteggia's Fracture / Q000601:surgery / Q000628:therapy; D011183:Postoperative Complications; D011859:Radiography; D011885:Radius Fractures / Q000601:surgery / Q000628:therapy*; D016059:Range of Motion, Articular; D013997:Time Factors; D014458:Ulna Fractures / Q000601:surgery / Q000628:therapy*