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[Hinged Elbow External Fixation for Severe Elbow Stiffness].

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Surgical arthrolysis significantly improves range of motion in severe elbow stiffness cases. External fixation did not offer additional benefits and increased complication risks, suggesting it

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Area of Science:

  • Orthopedic Surgery
  • Biomechanics

Background:

  • Severe elbow stiffness (ankylosis) severely limits daily activities and is challenging to treat.
  • Hinged external fixation offers static fixation with joint motion benefits.
  • Surgical arthrolysis aims to restore elbow function in cases of severe stiffness.

Purpose of the Study:

  • To evaluate range of motion improvements after elbow arthrolysis using a posterior approach.
  • To compare outcomes with and without the use of external fixation.

Main Methods:

  • Sixteen patients with grade 4 elbow stiffness underwent surgical arthrolysis.
  • Procedures involved a posterior extensile approach; eight patients also received external fixation.
  • Range of motion and Mayo Elbow Performance Score (MEPS) were assessed pre- and post-surgery.

Main Results:

  • Both groups showed significant improvement in MEPS and range of motion.
  • Average range of motion increased to 93° in the external fixation group and 88° in the non-fixation group.
  • Complications included temporary neurovascular irritation and pin-track infections in the external fixation group.

Conclusions:

  • Open arthrolysis provides substantial and lasting gains in motion for severe elbow contractures.
  • External fixation did not yield superior results and increased complication risks.
  • Precise surgical technique is crucial for successful arthrolysis of ankylosed elbows.