title: Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows.
abstract: BACKGROUND
  An ankylosed elbow is defined as an elbow having a range of motion of 0°. Movement is extremely limited. This study retrospectively analyzes the results of arthrolysis and hinged external fixation performed on 15 patients suffering from ankylosed elbows.
  
  
  METHODS
  Fifteen completely ankylosed elbows were treated by arthrolysis and hinged external fixation. Patients comprised nine men and six women, with a mean age of 37.93 years (37.93 ± 9.68) when arthrolysis was performed. Before surgery, the elbows were ankylosed at various angles ranging from 30° to 85°. Eleven patients underwent arthrolysis by medial and lateral approaches, three patients by the posterior approach, and one patient by posterior and lateral approaches. Hinged external fixators were applied to all patients. Subcutaneous anterior transposition of the ulnar nerve was performed in all patients.
  
  
  RESULTS
  All patients received satisfactory follow-up. The range of motion of the elbow improved from 0° preoperatively to a postoperative mean of 115.67° (115.67 ± 23.29). The Mayo Elbow Performance Score improved from a mean of 67.67 ± 11.00 to 86.67 ± 8.38 points, with excellent results in nine patients, good in five, and fair in one. This difference is statistically significant (t = -6.862; p < 0.001).
  
  
  CONCLUSIONS
  Open arthrolysis and monolateral hinged external fixation are effective in treating posttraumatic ankylosed elbow. Arthrolysis should be performed by a combination of lateral and medial approaches. In addition, routine hinged external fixation and anterior transposition of the ulnar nerve may improve the postoperative recovery of elbow stiffness.
authors.affiliation: Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China, ruanhongjiang@126.com.
authors.forename: Hong-jiang
authors.initials: HJ
authors.lastname: Ruan
authors.forename: Shen
authors.initials: S
authors.lastname: Liu
authors.forename: Cun-yi
authors.initials: CY
authors.lastname: Fan
authors.forename: Jun-jian
authors.initials: JJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D000844:Ankylosis / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D016267:External Fixators; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000150:complications; D000092464:Elbow Injuries