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The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases.

Bręborowicz M, Lubiatowski P, Długosz J, Ogrodowicz P, Wojtaszek M, Lisiewicz E, Zygmunt A, Romanowski L - Int Orthop (2013)

Bottom Line: 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°.

View Article: PubMed Central - PubMed

Affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, 28 Czerwca 2956r. No.135/147, Poznan, Poland.

ABSTRACT

Purpose: 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.

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Values of preoperative, intra-operative and follow-up active ranges of motion and the gains. Horizontal brackets—statistically significant p ≤ 0.05
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Fig3: Values of preoperative, intra-operative and follow-up active ranges of motion and the gains. Horizontal brackets—statistically significant p ≤ 0.05

Mentions: The average values of elbow extension, flexion and arc of motion have increased significantly, respectively by 33°, 18° and 51°, immediately at completion of the procedure. Increase in motion remained significant at final follow-up, although it was less than the immediate result with the respective values of 20°, 16° and 36° (Fig. 3). The number of patients with functional ROM (flexion ≥130°, extension ≤30°) increased from two to 14, and the number of cases with an almost functional ROM (flexion ≥120°, extension ≤40°) increased from nine to 38.


The outcome of open elbow arthrolysis: comparison of four different approaches based on one hundred cases.

Bręborowicz M, Lubiatowski P, Długosz J, Ogrodowicz P, Wojtaszek M, Lisiewicz E, Zygmunt A, Romanowski L - Int Orthop (2013)

Values of preoperative, intra-operative and follow-up active ranges of motion and the gains. Horizontal brackets—statistically significant p ≤ 0.05
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3936087&req=5

Fig3: Values of preoperative, intra-operative and follow-up active ranges of motion and the gains. Horizontal brackets—statistically significant p ≤ 0.05
Mentions: The average values of elbow extension, flexion and arc of motion have increased significantly, respectively by 33°, 18° and 51°, immediately at completion of the procedure. Increase in motion remained significant at final follow-up, although it was less than the immediate result with the respective values of 20°, 16° and 36° (Fig. 3). The number of patients with functional ROM (flexion ≥130°, extension ≤30°) increased from two to 14, and the number of cases with an almost functional ROM (flexion ≥120°, extension ≤40°) increased from nine to 38.

Bottom Line: 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°.

View Article: PubMed Central - PubMed

Affiliation: Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, 28 Czerwca 2956r. No.135/147, Poznan, Poland.

ABSTRACT

Purpose: 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.

Show MeSH
Related in: MedlinePlus