title: EVALUATION OF THE RESULTS OF SURGICAL TREATMENT OF POSTTRAUMATIC STIFFNESS OF THE ELBOW IN SKELETALLY MATURE PATIENTS.
abstract: OBJECTIVE
  To evaluate the results from surgical treatment of posttraumatic stiffness of the elbow in skeletally mature patients.
  
  
  METHODS
  Between October 2000 and October 2007, 45 elbows of 45 patients underwent surgical treatment performed by the Shoulder and Elbow Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Ten patients were treated arthroscopically and the remainder by open surgery. The minimum follow-up was six months, with a mean of 22 months. Their ages ranged from 17 to 72 years, with a mean of 36 years and three months. Males predominated, accounting for 60% of the cases. The dominant limb was involved in 56.5% of the cases. The clinical evaluation of the results was done by using the criteria of the American Medical Association (AMA), as modified by Bruce; the Mayo Elbow Performance Score (MEPS); and measurements on the gain of flexion-extension arc and the final range of motion.
  
  
  RESULTS
  According to the AMA criteria, as modified by Bruce, 42.2% of our results were satisfactory, whereas 77.8% were satisfactory according to MEPS. The mean postoperative flexion-extension arc was 106°, and the main gain in range was 46°. The evaluation of the variables showed that patients with an initial flexion arc greater than 90° achieved a greater final flexion-extension arc, and those with an initial extension less than or equal to 60° gained greater range of motion.
  
  
  CONCLUSIONS
  Surgical treatment of posttraumatic stiffness of the elbow in skeletally mature individuals was shown to be satisfactory according to MEPS, but unsatisfactory according to AMA. We observed that the patients with preoperative flexion greater than 90° evolved with a greater flexion-extension arc after surgical treatment, while those who had contracture with extension less than or equal to 60° gained a greater range of motion.
authors.affiliation: Assistant Professor and Head of the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
authors.forename: Alberto Naoki
authors.initials: AN
authors.lastname: Miyazaki
authors.affiliation: Assistant Professor and Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fregoneze
authors.affiliation: Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
authors.forename: Pedro Doneux
authors.initials: PD
authors.lastname: Santos
authors.affiliation: Attending Physician in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
authors.forename: Luciana Andrade
authors.initials: LA
authors.lastname: da Silva
authors.affiliation: Trainee in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Giunta
authors.affiliation: Trainee in the Shoulder and Elbow Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
authors.forename: Lucio Norio
authors.initials: LN
authors.lastname: Watanabe
authors.affiliation: Adjunct Professor and Clinical Head of the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo; Member and Academic Coordinator of the Shoulder and Elbow Group.
authors.forename: Sérgio Luiz
authors.initials: SL
authors.lastname: Checchia
keywords: Contracture; Elbow; Joint; Range of Motion; Surgery; Treatment Outcome