title: Early surgical anterior release for congenital and isolated elbow contracture in flexion: a case report of a 16-month-old child.
abstract: Isolated congenital elbow contracture is a rare upper-extremity disorder and there are few data about management of this condition. Authors report their experience after aggressive management of children with isolated congenital elbow contracture in flexion. Because of total absence of range of motion (ROM) improvement despites physical therapy (ROM 90-120°) and bone deformity, an anterior surgical release of the elbow was performed through an extensive lateral approach, at sixteen months of age. After surgery, this child was treated by three casts at maximal gained extension followed by sequential Turnbuckles splints. After five years of follow-up, the result was excellent with ROM 5-135°, normal function and absence of growth disturbance. The limiting factor of this protocol was excessive traction in elbow extension on the neurovascular structures, especially the radial nerve. This treatment represents an aggressive management with multiple general anaesthesia, but was found to be a valid option.
authors.affiliation: Pediatric Orthopaedics Department Pr Kohler and Pr Chotel, Lyon Mother and Child Teaching Hospital Center, Civilian Hospital Group of Lyon, Lyon 1 Claude-Bernard University, 59, boulevard Pinel 69677 Bron, France.
authors.forename: O
authors.initials: O
authors.lastname: Cantin
authors.forename: G
authors.initials: G
authors.lastname: Mezzadri
authors.forename: A
authors.initials: A
authors.lastname: Gazarian
authors.forename: K
authors.initials: K
authors.lastname: Abelin-Genevois
authors.forename: R
authors.initials: R
authors.lastname: Kohler
authors.forename: J
authors.initials: J
authors.lastname: Bérard
authors.forename: F
authors.initials: F
authors.lastname: Chotel
mesh_terms: D002370:Casts, Surgical; D003286:Contracture / Q000175:diagnosis / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D004576:Electromyography; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular