Outcomes of Post-traumatic Stiff Elbow Arthrolysis

Abstract

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.