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Closed manipulation under anesthesia for pediatric post-traumatic elbow arthrofibrosis
Ajinkya A Rane1, Brittany N Garcia1, Angela A Wang1
1Department of Orthopedic Surgery, University of Utah Hospital, Salt Lake City, UT, USA.
Journal of Shoulder and Elbow Surgery
|January 19, 2020
Summary
Closed manipulation under anesthesia (CMUA) significantly improves elbow range of motion in pediatric patients with post-traumatic elbow arthrofibrosis (PEA). This nonoperative procedure offers a reliable solution for restoring function after trauma.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Post-traumatic elbow arthrofibrosis (PEA) limits range of motion (ROM) in pediatric patients following elbow trauma.
- Closed manipulation under anesthesia (CMUA) is a nonoperative intervention to improve ROM in these cases.
- Limited outcome data exist to support the efficacy of CMUA for pediatric PEA.
Purpose of the Study:
- To evaluate the effectiveness of CMUA in improving elbow ROM in pediatric patients with PEA.
- To assess the safety and reliability of CMUA as a nonoperative treatment for PEA.
Main Methods:
- Retrospective chart review of pediatric patients (<18 years) who underwent CMUA for PEA between 2005 and 2015.
- Data collected included demographic information and pre- and post-manipulation elbow ROM.
- Paired t-tests were used to compare ROM changes.
Main Results:
- Thirteen pediatric patients (mean age 12.2 years) were included.
- Significant improvements observed in elbow flexion (22°) and extension (29°).
- Average motion arc increased from 60° to 110° post-CMUA.
Conclusions:
- CMUA is a valuable and reliable nonoperative procedure for improving PEA in pediatric patients.
- It offers a viable alternative when other nonoperative interventions have been exhausted.
