title: The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases.
abstract: OBJECTIVE
  The aim of this study was to evaluate the results of elbow arthrolysis according to the surgical approach, durability after arthrolysis and the severity of contracture.
  
  
  METHODS
  The study includes a cohort of 100 consecutive patients treated in our institution between 1986 and 2008. The indication for surgery was loss of mobility. This was the result of fractures, dislocation, simultaneous fracture/dislocation or other non-traumatic causes. All patients underwent open elbow release via one of four approaches (42 lateral, 44 medial, six combined medial-lateral and eight posterior). They were clinically evaluated at a minimum of 24 months after arthrolysis.
  
  
  RESULTS
  The average ranges of elbow extension, flexion and arc of motion had increased significantly at the follow up, respectively, by 20°, 16° and 36°. No significant difference was found with regard to surgical approach. However, we noticed significant deterioration of intra-operative average extension and arc of motion (AOM) over the follow up period, respectively, by 13° and 14°. The number of patients with AOM of 100° or more increased from three patients preoperatively to 28 postoperatively.
  
  
  CONCLUSIONS
  Open elbow arthrolysis is a successful method of treatment of elbow contracture. Results are durable, but there is some postoperative deterioration of extension gained during surgery. We may anticipate that at the final stage we shall obtain an average of 86% of intra-operative arc of motion. Patients with the most severe contractures have the best gains.
authors.affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, 28 Czerwca 2956r. No.135/147, Poznan, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Bręborowicz
authors.forename: Przemysław
authors.initials: P
authors.lastname: Lubiatowski
authors.forename: Jan
authors.initials: J
authors.lastname: Długosz
authors.forename: Piotr
authors.initials: P
authors.lastname: Ogrodowicz
authors.forename: Marcin
authors.initials: M
authors.lastname: Wojtaszek
authors.forename: Ewa
authors.initials: E
authors.lastname: Lisiewicz
authors.forename: Adam
authors.initials: A
authors.lastname: Zygmunt
authors.forename: Leszek
authors.initials: L
authors.lastname: Romanowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult