Open arthrolysis for functional restoration in post-traumatic elbow stiffness

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Rehabilitative Medicine

Background:

• Post-traumatic elbow stiffness is a debilitating condition often resulting from fractures, dislocations, or sprains.
• Previous treatment by native bonesetters can lead to fixed elbow extension, limiting functional range of motion.
• Restoring elbow function is crucial for patients' quality of life and daily activities.

Purpose of the Study:

• To evaluate the efficacy of open arthrolysis in restoring elbow function in patients with post-traumatic stiffness.
• To assess the improvement in flexion range and reduction in extension loss following the surgical procedure.
• To determine the optimal timing for arthrolysis to achieve the best outcomes.

Main Methods:

• A prospective study involving nine patients (seven children, two adults) with post-traumatic elbow stiffness.
• All patients underwent open arthrolysis via a posterior approach.
• Pre-operative and 6-month post-operative measurements of elbow flexion and extension loss were recorded using a goniometer.

Main Results:

• Significant improvement in mean flexion range from 3.6 to 88.3 degrees (P < 0.01).
• Significant reduction in mean extension loss from 33.8 to 12.1 degrees (P < 0.01).
• Improved flexion attributed to surgery; improved extension attributed to physiotherapy.

Conclusions:

• Open arthrolysis is a highly effective procedure for restoring functional range of motion in post-traumatic elbow stiffness, especially when the elbow is fixed in extension.
• Early intervention, ideally within one year of injury, yields the best results.
• A combination of surgical intervention and physiotherapy is recommended for optimal outcomes.