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Posterior elbow release and humeral osteotomy for patients with arthrogryposis

Dan A Zlotolow1, Scott H Kozin

  • 1Temple University School of Medicine, Shriners Hospital for Children, Philadelphia, PA, USA. dzlotolow@yahoo.com

The Journal of Hand Surgery
|April 10, 2012
PubMed

Insights

Children with arthrogryposis struggle with self-feeding due to limited arm mobility. A combined surgical approach of posterior elbow capsular release and humeral osteotomy improves upper extremity function, enabling patients to reach their mouths more effectively.

Area of Science:

  • Orthopedic surgery
  • Pediatric rehabilitation
  • Upper extremity function

Background:

  • Children with arthrogryposis exhibit limited shoulder external rotation and elbow flexion, impairing self-feeding abilities.
  • Surgical elbow release alone may not restore functional hand-to-mouth reach if shoulder rotation remains restricted.

Purpose of the Study:

  • To evaluate the efficacy of a combined posterior elbow capsular release and humeral osteotomy in improving functional reach for children with arthrogryposis.
  • To assess the benefits of this combined surgical technique in enhancing self-feeding capabilities.

Main Methods:

  • A retrospective review of pediatric patients with arthrogryposis undergoing combined posterior elbow capsular release and humeral osteotomy.
  • Assessment of functional outcomes, focusing on the ability to reach the mouth post-operatively.

Main Results:

  • The combined surgical approach significantly improved the ability of patients to position their forearms and hands for functional reach.
  • This technique offers a viable solution for patients with persistent limitations in shoulder external rotation after elbow surgery.

Conclusions:

  • Simultaneous posterior elbow capsular release and humeral osteotomy is an effective strategy to enhance upper extremity function in children with arthrogryposis.
  • This combined procedure provides a better functional position for the forearm and hand with minimal additional surgical risk.

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