Operative treatment of elbow contracture in patients twenty-one years of age or younger.
BACKGROUND
Elbow contracture is a recognized sequela of traumatic and developmental elbow disorders, but little information is available regarding the surgical treatment of elbow stiffness in the pediatric population.


METHODS
Thirty-seven patients who had had open surgical release of an elbow contracture at a mean age of sixteen years (range, ten to twenty years) were retrospectively studied after a mean duration of follow-up of fifteen months (range, six to forty-four months). The elbow contracture was posttraumatic in twenty-eight patients. The operation consisted of a capsular release with removal of osseous impediments to motion as necessary. No patient had muscle or tendon-lengthening.


RESULTS
The total arc of motion improved from a mean of 66  preoperatively to a mean of 94  postoperatively; however, only twenty-eight patients (76%) had an improvement of 10  and only seventeen (46%) achieved a functional arc of motion of 100  (from 30  to 130 ). Two patients lost motion after surgery. These results are less favorable than the results of previous studies of both pediatric and adult patients. Patients in whom the contracture had been caused by a simple dislocation of the elbow or an extra-articular fracture tended to have better results than those in whom the contracture was due to other causes.


CONCLUSIONS
The results of surgical treatment of elbow stiffness in pediatric patients are less favorable and less predictable than those in adult patients.
Stans
Anthony A
AA
Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Maritz
N G J
NG
O'Driscoll
Shawn W
SW
Morrey
Bernard F
BF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D003286:Contracture / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome