ElbowSurgical release of elbow stiffness after internal fixation of intercondylar fracture of the distal humerus
Section snippets
Patient demographics
Medical records of patients who had undergone surgical release for elbow stiffness after ORIF of intercondylar fracture during the period from July 2001 to March 2008 were retrospectively reviewed. Surgical release was indicated when the total range of motion (ROM) was less than 100° despite physical therapy for at least 6 months after ORIF. The criteria for inclusion were (1) union of fracture as determined radiologically and clinically, (2) skeletally mature elbows, (3) normal anatomy and
Overall results
The mean flexion contracture decreased significantly from 35.8° preoperatively to 14.2° (range, 0°-40°) postoperatively (P < .05). The mean flexion arc was significantly improved from 96.0° preoperatively to 119.0° postoperatively (range, 90°-135°; P < .05). The mean total ROM increased from 60.2° preoperatively to 104.8° postoperatively, with a mean improvement of 44.6° (range, 10°-100°; Table I). Of the 24 elbows, 17 (71.8%) obtained a total ROM of 100° or greater, and 6 (25%) gained a
Discussion
Our series showed that contracture release in patients with elbow stiffness after ORIF for an intercondylar fracture of the distal humerus resulted in significant improvement of the total arc of motion in most patients. This result is consistent with the observations in previous studies reporting the results of surgical release of stiff elbows.6, 19, 22, 26, 27 Although there is extensive literature discussing the elbow stiffness after intercondylar fracture repair, no studies have addressed
Conclusions
Contracture release of stiff elbow that developed after treatment with ORIF for intercondylar fracture resulted in significant improvements in total ROM. However, the potential risk of refracture should be considered in determining whether to remove the hardware in this situation.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Cited by (23)
Randomized trial for the treatment of post-traumatic elbow stiffness: surgical release vs. rehabilitation
2020, Journal of Shoulder and Elbow SurgeryCitation Excerpt :However, the preoperative treatment ROM in our study was 71° for the conservative group, whereas for Lindenhovius et al16 it was 51°. Regarding the increase of flexion-extension ROM, the surgical group presented the value of 41°, similar to those reported by Higgs et al11 and Koh et al,15 superior to the 17° increase in the conservative group. Ayadi et al2 observed superior flexion-extension increases after surgical treatment, with an average of 51°.
Functional outcome following elbow release and hardware removal after bicolumnar fixation of distal humeral fractures
2020, InjuryCitation Excerpt :Of the thirty patients who were available (mean 19 year follow-up), two patients underwent a hardware removal and elbow release. In 2013, Koh et al. reported on twenty-four patients who underwent a contracture release following ORIF for a distal humeral intercondylar fracture [8]. Sixteen of those patients underwent concomitant hardware removal [8].
Use of a modified Outerbridge-Kashiwagi procedure for the treatment of posttraumatic elbow sequelae
2019, Journal of Shoulder and Elbow SurgeryOpen surgical elbow contracture release after trauma: results and recommendations
2018, Journal of Shoulder and Elbow SurgeryOpen arthrolysis with pie-crusting release of the triceps tendon for treating post-traumatic contracture of the elbow
2016, Journal of Shoulder and Elbow Surgery
This study was approved by the Institutional Review Board of Samsung Medical Center (IRB number: 2012-02-086-001).