[Results of posttraumatic elbow arthrolyses: a prospective study]

Posttraumatic stiffened joints are mostly well restored by means of operation, however, the range of motion remains restricted by secondary soft tissue shrinking and scarring. Conservative treatment yields only limited success rates. Open arthrolysis is a useful tool in regaining function; in postoperative treatment, immediate passive mobilization and prevention of heterotopic ossification are most important.

Sixty-nine patients were arthrolyzed on average 25.3 months post trauma, with an average of 1.5 previous operations (range 0-8) and a follow-up period of 14.7 months.

By means of the open arthrolysis, an increase in range of motion for flexion and extension of 62.3 degrees (preoperative 38.4 degrees, postoperative 87.9 degrees, at follow-up 100.7 degrees ) and 29.3 degrees for pro- and supination was achieved on average. The highly important range of motion between 0-30 degrees and 110 degrees was accomplished in 78.2 % of the patients. We analyzed the postoperative management including irradiation, pharmacological ossification prophylaxis with indomethacin and immediate passive motion. Whenever the time to arthrolysis exceeded 9 months, clearly worse results were obtained, thus we measured a difference in the correlated increase of motion from 54.3 % - 34.6 %. Comparisons of our results with German (after Blauth and Hipp) and French (after Cauchoix and Deburge) standard follow-up forms are made, and the rehabilitation program is underlined and explained. Another task of this study was to discuss the complication rate.