Posttraumatic contracture of elbow treated with intraarticular technique.
BACKGROUND
Posttraumatic contracture of the elbow (either flexion or extension) is sometimes very disabling. However, an absolutely convincing surgical technique has not yet been defined in the literature. We developed an intraarticular technique to concomitantly treat both intraarticular and extraarticular lesions with one posterior incision.


METHODS
Twenty consecutive adult patients were treated. After the olecranon was osteotomized, all intraarticular pathologies and the anteroposterior capsule were corrected completely. The olecranon was then stabilized with the modified tension band wiring technique. Immediately postoperatively, continuous passive movement was performed, and range-of-motion exercise of the elbow was encouraged continuously.


RESULTS
All 20 patients were followed up for a median of 3.8 (range 2.1-6.6) years. The satisfactory rate was 95% (19 of 20, p<0.001). The flexion contracture improved from an average of 42 to 13 deg (p<0.001), and the maximal flexion improved from an average of 89 to 131 deg (p<0.001). The arc of motion improved from an average of 47 to 118 deg (p<0.001). The sole unsatisfactory patient still had 20-110 deg of arc of motion. There were no evident complications noted.


CONCLUSIONS
Compared with other techniques, we recommend this one due to its high satisfactory rate and low complication rate.
Wu
Chi-Chuan
CC
Department of Orthopedics, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, 333 Kweishan, Taoyuan, Taiwan. ccwu@mail.cgu.edu.tw
D000328:Adult; D003286:Contracture / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive; D019637:Orthopedic Procedures; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D000092464:Elbow Injuries