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Incidence of postoperative elbow contracture release in New York State
Mark A Schrumpf1, Stephen Lyman, Huong Do
1Center for Clinical Outcomes Research and Hand Surgery, Hospital for Special Surgery, New York, New York, USA.
Purpose:
To determine the incidence of elbow contracture requiring release after surgically treated elbow trauma and to identify patient, injury, and treatment factors that may predict contracture development.
Methods:
The New York Statewide Planning and Research Cooperative System database identified 32,708 patients who were surgically treated for elbow trauma from 1997 to 2009. The database identified 270 of those patients who underwent subsequent contracture release. The median time from index fracture procedure to contracture release was 31 weeks.
Results:
Patients requiring a contracture release were younger (43 vs 56 y) and more commonly male (57%). Injuries classified as severe were more common in the contracture group (11% vs 5%), as were open fractures (17% vs 11%). A multivariate regression analysis revealed that patients with burns were 16 times more likely to require surgical contracture release, and the use of internal fixation to treat the fracture was protective against contracture development.
Conclusions:
The incidence of elbow contractures treated with release after surgically treated elbow trauma was low but increased with the severity of the initial trauma.