Open arthrolysis for functional restoration in post-traumatic elbow stiffness

A prospective study of nine patients who had elbow stiffness after trauma and had open arthrolysis to restore function is presented: seven were children aged 6-10, two were adults--six males and three females. Five patients had supracondylar fracture as the initial lesion, one had posterior dislocation of the elbow and three had elbow sprains. They were all previously treated by native bonesetters and presented with elbow stiffness and fixed extension of the elbow. All had open arthrolysis using a posterior approach. The flexion range and loss of extension were measured pre-operatively and at 6 months after surgery using a goniometer. Both values were compared using the Student's t-tests for correlated samples. There was a significant improvement in the flexion range from a mean pre-operative value of 3.6 degrees to 88.3 degrees post-operatively (t=8.87, P > 0.01) and in the extension loss from a mean value of 33.8 degrees pre-operatively to 12.1 degrees post-operatively (t=7, P < 0.01). The improved flexion range was due to the operation while the improvement in the loss of extension was due to physiotherapy. Useful functional range of movement was restored in all patients. The operation is a very useful procedure and is recommended for patients with post-traumatic elbow stiffness when the elbow is fixed in the extended position. Best results are obtained if arthrolysis is done within 1 year of injury.