Mid-Term Outcomes of Arthroscopic Treatment in Patients with a Stiff Elbow (original) (raw)
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Open versus Arthroscopic Treatment of Post-Traumatic Stiff Elbow
Open Journal of Orthopedics, 2014
Thirty three patients with post-traumatic stiff elbow were divided into two groups. The first group included 18 patients with an average age of 31.05 years treated by open arthrolysis. The second included 15 patients with an average age of 31.66 years treated by arthroscopic method. The results were evaluated using the Mayo clinic score and DASH score for elbow function. In the open group, after an average period of follow-up 19.33 months, the average range of flexion-extension movement improved from 51.11˚ to 103.94˚. The average Mayo clinic score improved from 63.38 to 92.83 and the average DASH score improved from 68.1 to 40.23. There were 13 cases (72.22%) excellent, 4 cases (22.22%) good and 1 case (5.55%) with the poor result. In the arthroscopic group, after an average period of follow-up 17.73 months, the average range of flexion-extension movement improved from 59.46˚ to 101.53˚. The average Mayo clinic score improved from 62.93 to 92.73 and the average DASH score improved from 69.25 to 46.4. There were 10 cases (66.66%) excellent, 3 cases (20%) good and 2 cases (13.33%) with the poor result. Both open and arthroscopic treatment can be effective in treatment of post-traumatic stiff elbow. Arthroscopic treatment is associated with less post-operative pain and morbidity. However, open treatment provides better range of motion and marked improvement of elbow function.
The Outcome of Elbow Release Surgery in Patients with Elbow Stiffness Caused by Different Etiologies
Shafa Orthopedic Journal
Background: Elbow stiffness is a debilitating condition with different etiologies including trauma, head injury, and burns, which seriously interferes with the patient's daily activities. Objectives: Here, we aimed to report the outcome of elbow release surgery in patients with elbow stiffness caused by different etiologies. Methods: In a retrospective study, the outcome of surgery was evaluated in 18 patients with elbow stiffness. The indication for surgery was the functional loss of elbow range of motion that failed at least six months of conservative management. Elbow range of motion was evaluated before and after the surgery. Mayo elbow performance score (MEPS) was used to assess elbow function at the final follow-up session. Results: The mean follow-up period of the patients was 4.5 ± 2.6 years, ranging from 2 to 10 years. The etiology of stiffness was trauma in 11 cases, central nervous system injury in six patients, and burns in one patient. The mean pre-operative supination, pronation, and flexion arc improved by 15.3°, 20.9°, and 62.2°at the final follow-up evaluation, respectively (P = 0.028, P = 0.008, and P < 0.001, respectively). The mean MEPS of the patients was 85 ± 9.1, ranging from 65 to 95. According to the MEPS scores, the functional outcome was excellent in 8 (44.4%) patients, good in 7 (38.9%) patients, and fair in 3 (16.7%) patients. Conclusions: The release of stiff elbow could be regarded as an effective treatment that provides an acceptable gain in the range of motion and considerable improvement of elbow function.
[Arthroscopic management of the stiff elbow]
Chirurgie de la main, 2006
Elbow stifness has diverse etiologies, the most common being post-trauma. It appears that both arthroscopic and open techniques can achieve satisfactory results when employed properly. Their use is dictated both by the surgeon's level of expertise and an accurate preoperative assessment. When the release is done arthroscopically, collateral ligament stability is not compromised and morbidity from surgical dissection is minimized. The technique of arthroscopic release is described with all steps and difficulties. Arthroscopic capsular release is a technically demanding procedure that requires meticulous attention to detail and should only be attempted by surgeons with extensive experience in elbow arthroscopy.
Arthroscopic arthrolysis for posttraumatic elbow stiffness
Journal of Shoulder and Elbow Surgery, 2011
Background: Loss of motion of the elbow joint is a common finding after elbow trauma. Restoration of motion of the posttraumatic stiff elbow can be a difficult, time-consuming, and costly challenge. Arthroscopic capsular release of stiff elbows has recently been introduced as a safe but technically demanding technique. The outcome in 27 patients treated by arthroscopic capsular release was assessed. Materials and methods: We evaluated 27 patients (17 women) who were an average age of 42 years (range, 14-65) at 3, 12, and 24 months after arthroscopic capsular release of a posttraumatic stiff elbow. Range of motion (ROM) and Elbow Function Assessment (EFA) were measured. Results: Before the arthroscopic procedure, the mean flexion was 123 (SD 8 ), extension was 24 (SD 9 ), and total ROM was 99 (SD 11 ), and after surgery, flexion improved significantly to 133 (SD 5 ), extension to 7 (SD 6 ), and total ROM to 125 (SD 10 ). The mean (SD) EFA showed improvement from 69 (SD 4) preoperatively to 91 (SD 4) postoperatively. The postoperative outcomes at 3, 12 and 24 months were similar. One postoperative superficial infection of the lateral portal occurred and was successfully treated with oral antibiotics. No vascular or neurologic complications were noted. Discussion: Historical data underscore the fact that arthroscopic release of posttraumatic elbow contracture is technically demanding but can effective improve the elbow arc of motion. Conclusion: Arthroscopic capsular release of the elbow is a safe and reliable treatment for patients with a posttraumatic elbow contracture.
Outcomes of Post-traumatic Stiff Elbow Arthrolysis
Journal of Academic Research in Medicine, 2020
Objective: In this study, the results of open release surgeries performed for the stiff elbows which were caused by intrinsic, extrinsic or by combination of both factors were evaluated. Methods: Twenty-three elbows of 22 patients who could not perform functional elbow motions were surgically treated between January 2005 and December 2012. The mean age was 30.6±11.4 years (16 to 67 years), and the average follow-up period was 81 months (58 months to 12 years). Elbow arc of motions was recorded pre-and postoperatively. Patients were evaluated clinically by using quick Disabilities of the Arm, Shoulder and Hand (DASH) self-report questionnaire, and MAYO elbow performance scores. Results: The mean preoperative elbow arc of motion was 42 degrees (0-90), and it became 109 degrees (70-140) postoperatively after at least 58-month follow-up. The average increase was 67.8±25 degrees (30-125). The mean Quick DASH score was 18.2±12.7 (6.8 to 63.6). According to MAYO elbow rating system, one patient who had experienced infection following the initial fracture treatment had poor result, three patients had fair results, 17 patients had good results, and one patient who had bilateral elbow stiffness had excellent results. Conclusion: Although good results can be achieved by open release of the stiff elbows, one must keep in mind that preventing the stiffness rather than solving this problem would bring better results. As 15 patients with stiff elbows in this study had a previous surgery performed for an elbow region fracture, stabile fixation, meticulous hemostasis, shorter immobilization period and early rehabilitation can be considered as the most important steps for avoiding elbow stiffness where surgery is indicated.
Arthroscopic Treatment of Stiff Elbow
ISRN Surgery, 2011
Contracture of the elbow represents a disabling condition that can impair a person's quality of life. Regardless of the event that causes an elbow contracture, the conservative or surgical treatment is usually considered technically difficult and associated with complications. When the conservative treatment fails to restore an acceptable range of motion in the elbow, open techniques have been shown to be successful options. More recently the use of arthroscopy has become more popular for several reasons. These reasons include better visualization of intra-articular structures, less tissue trauma from open incisions, and potentially the ability to begin early postoperative motion. The purpose of this paper is to review the indications, complications, and results of arthroscopic management of a stiff elbow.
Arthroscopic Treatment of Posttraumatic Elbow Pain and Stiffness
The American Journal of Sports Medicine, 1994
Nineteen consecutive cases of posttraumatic arthrofi brosis of the elbow secondary to a fracture or fracture- dislocation and treated with arthroscopic debridement and manipulation were retrospectively reviewed. All of the patients had pain and stiffness in their elbows, and all had failed a conservative therapy program. All 19 patients were followed postoperatively for an average of 29 months (range, 12 to 51). One hundred-point scoring systems were used to evaluate subjective (pain, swell ing, locking, and activities) and objective (range of mo tion) results. The average preoperative subjective score of 39 im proved to 91 postoperatively (P= 0.0001); the objective score improved from 46 preoperatively to 81 postop eratively (P = 0.0001). Extension improved from a mean of 29° to 11 °; flexion improved from an average of 123° to 134°. Fourteen patients had limitations in their sports activity preoperatively; 11 were able to return to their preinjury levels of activity after surgery....
Acta Orthopaedica, 2002
We treated 46 consecutive patients (47 elbows) suffering from posttraumatic contracture of the elbow joint with operative release. A lateral approach was used to perform a capsulectomy after release of the extensor muscles in 23 elbows. An additional medial approach was used to excise ulnar adhesions and perform a more extensive capsulectomy and an ulnar nerve neurolysis in 24 elbows. Postoperative rehabilitation consisted of immediate passive range-of-motion exercises. The results were assessed after average 10 (2-18) years.
Assessment Of Results Of Open Arthrolysis In Post Traumatic Stiff Elbows
The Internet Journal of …, 2009
Background: Surgical management of posttraumatic elbow stiffness has been reported with poor outcome following treatment. Elbow arthrolysis done in any age group and even very old cases yield good results. The goal of our study was to assess the outcome in improvement of the range of motion of the elbow after surgical release by a tailor-made approach to yield good result.Materials and Methods: A retrospective and prospective study was conducted between oct 2006 to oct 2008 at department of orthopaedic surgery, G.S.V.M. medical college Kanpur. This study includes 25 cases of elbow stiffness due to various types of injuries. All the cases were treated with elbow arthrolysis if there was no progress after adequate supervised conservative management except in unreduced dislocations. All the cases were followed up for a minimum period of 2 years. Overall outcome was rated with the functional scoring system by Mayo Clinic Performance Index and Krishnamoorthy et. al (1976).Results: Nineteen(76%) out of 25 patients had excellent results with a mean preoperative range of motion of 38.4°,and postoperative range of motion of 106.80° with net gain in range of motion of 68.40° (' t ' test value is 9.33, P < 0.01). One (4%) of the patient had elbow instability. In cases where release was performed from three months to six months had mean gain of 76.92°. Cases in which release was performed after six months had gain of 63.57°. The mean pre-operative Mayo Clinic Performance Index score was 66°±9.35° and mean post-operative score was 95.4°±13.38° with average gain of 29.4°. (t test value 9.005, p<.001). According to Krishnamoorthy et al functional scoring system (1976), 19 patients (76%) achieve good result and 5 cases (20%) had fair result and 1 case (4%) had poor result.Conclusions: In cases of posttraumatic elbow stiffness after a failed initial conservative treatment, early arthrolysis with sequential surgical soft tissue release yields good result than delayed surgery.
Open arthrolysis versus arthroplasty in the treatment of posttraumatic elbow stiffness
Romanian Journal of Rheumatology
Elbow stiffness is a common problem following trauma to the elbow. Sixty-seven patients with posttraumatic elbow stiffness were surgically treated between 1985 - 2000. Sixty-one were clinically reviewed after a mean follow-up of 15 years (range: 7 to 19 years). The initial trauma had resulted in 8 intrinsic, in 31 extrinsic and in 28 mixed lesions. The mean preoperative flexion – extension arc of motion, was 46°. After an unsuccessful conservative treatment, open surgical arthrolysis was performed in 59 patients with exclusively extrinsic or mixed lesions, through a lateral approach combined with a medial approach when deemed necessary. In patients with complex intrinsic lesions was performed 3 resection arthroplasty and 5 total elbow arthroplasty. At final follow-up, the mean arc of motion of the elbow was significantly improved to 100° in 56 patients who had undergone open arthrolysis; 3 were lost to follow-up. Among the 3 patients who had undergone arthroplasty resection, only on...