Elsevier

Journal of Shoulder and Elbow Surgery

Volume 11, Issue 6, November–December 2002, Pages 624-629
Journal of Shoulder and Elbow Surgery

Arthroscopic treatment of post-traumatic elbow contracture

https://doi.org/10.1067/mse.2002.126770Get rights and content

Abstract

The purpose of this study was to evaluate range of motion and patient-reported outcome after complete arthroscopic release of post-traumatic elbow contracture. Fourteen consecutive patients who underwent elbow arthroscopy and capsular release were reviewed retrospectively at a minimum follow-up of 1 year. Pain and range of motion were measured. Patient outcome was assessed with the American Shoulder and Elbow Surgeons Elbow Assessment Form. Mean self-reported satisfaction on a visual analog scale was 8.4 out of 10. Only 6 patients continued to have pain, with a mean maximum pain score of 4.6 out of 10. Flexion increased from a mean of 117.5° to 133°, and extension improved from a mean of 35.4° to 9.3°. In those patients with a preoperative arc of motion less than 100° (10 patients), the mean arc of motion improved from 69° to 119°. All patients had improved function after the procedure, with a mean self-reported functional ability score of 28.3 out of 30. There were no neurovascular complications. The improvement in range of motion and functional outcome compares favorably with open-release procedures. Combined with the potential benefits of improved joint visualization and low surgical morbidity, arthroscopic release of post-traumatic elbow contracture appears to be a reasonable alternative to open techniques. (J Shoulder Elbow Surg 2002;11:624-9)

Section snippets

Materials and methods

Between May 1998 and October 1999, 14 elbows in 14 consecutive patients were treated with an arthroscopic procedure for post-traumatic elbow contracture. No open releases were performed during this particular collection period, as no patient met the criteria for exclusion. All patients were available for review at a minimum follow-up of 1 year (range, 12-29 months). There were 8 men and 6 women. The mean age at the time of surgery was 36.9 years (range, 18-57 years). The dominant elbow was

Pain relief

In addition to loss of motion, 11 of the 14 patients also reported pain as a primary complaint. At the latest follow-up, 6 continued to report some pain. In 4, the pain was minimal and occurred only with activity (mean maximum pain score, 3.25/10). The remaining 2 patients complained of some pain at rest. No patient had worse pain, and none had new pain develop as a result of the procedure. All elbows were stable both preoperatively and at the latest follow-up examination, and all had normal

Discussion

Early reports on open surgical release procedures for the post-traumatic stiff elbow generally had satisfactory results.4, 20, 21 Urbaniak et al19 reported a mean improvement in extension from 48° to 19° in 15 patients. In a series of 7 patients, Husband and Hastings7 reported a mean improvement in extension from 45° to 12°, with flexion improving from 116° to 129°. More recently, Mansat and Morrey12 reported improved range of motion in 89% of 38 elbows, with a mean total gain in the

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