title: Progressive surgical release of a posttraumatic stiff elbow. Technique and outcome after 2-18 years in 46 patients.
abstract: We treated 46 consecutive patients (47 elbows) suffering from posttraumatic contracture of the elbow joint with operative release. A lateral approach was used to perform a capsulectomy after release of the extensor muscles in 23 elbows. An additional medial approach was used to excise ulnar adhesions and perform a more extensive capsulectomy and an ulnar nerve neurolysis in 24 elbows. Postoperative rehabilitation consisted of immediate passive range-of-motion exercises. The results were assessed after average 10 (2-18) years. Before surgery, the mean active arc of motion was 45 (SD 36) degrees, which improved to 99 (SD 34) degrees after release. 7 patients had transient ulnar paresthesia, 4 recurrent stiffness, which did not become worse after surgery, 1 was reoperated on and 2 developed a postoperative infection, which responded to antibiotic treatment after a few months. No patient suffered from joint instability, or an increase in pain. 44 patients were satisfied with the result at the latest follow-up. We found similar improvement in both treatment groups.
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands. orthopaedie@amc.uva.nl
authors.forename: René K
authors.initials: RK
authors.lastname: Marti
authors.forename: Gino M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
authors.forename: Leendert
authors.initials: L
authors.lastname: Blankevoort
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003286:Contracture / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology / Q000601:surgery; D010043:Outcome and Process Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology; D013997:Time Factors; D014459:Ulnar Nerve / Q000503:physiopathology / Q000601:surgery; D000092464:Elbow Injuries