2017, Number 5
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Acta Ortop Mex 2017; 31 (5)
Post-traumatic elbow stiffness: arthroscopic release, short-term results
Bustamante-Suárez de Puga D, Cebrián-Gómez R, Villegas-Robles E, Sanz-Reig J, Más-Martínez J, Verdú-Román CM, Morales-Santías M, Martínez-Giménez E
Language: Spanish
References: 18
Page: 233-238
PDF size: 231.92 Kb.
ABSTRACT
Background: Open «arthrolysis» has been the standard treatment for elbow stiffness, with good results. However, the associated complications of open arthrolysis and the advancements in arthroscopic surgery have allowed including the latter as an additional approach.
Material and methods: Between January 2014 and March 2016, 6 patients with posttraumatic elbow stiffness underwent arthroscopic surgery by the same surgical team. Pre- and post-operative assessment included pain with a numerical visual analogue scale, elbow joint range of motion with a goniometer and the Mayo Elbow Performance Index questionnaire.
Results: Mean patient follow-up was 14.5 months. The mean VAS score decreased from 4.5 to 0.3. The mean elbow range of motion increased from 55.3
o to 130
o, with a mean gain of 75
o. The mean MEPI questionnaire score went from 46.6 to 95, with a mean gain of 48.4 points. The procedures associated with arthroscopic «arthrolysis» included removal of the synthesis material from the 3 olecranon fractures. No cases of heterotopic ossification, superficial infection or ulnar neuropathy were reported. None of the patients required surgical reintervention to perform a new «arthrolysis», whether arthroscopic or open.
Conclusions: Arthroscopic release to treat posttraumatic elbow stiffness is an effective technique to restore mobility in the short term.
REFERENCES
Mellena JJ, Lindenhovius AL, Jupiter JB: The posttraumatic stiff elbow: an update. Curr Rev Musculoskelet Med. 2016; 9: 190-8.
Cai J, Wang W, Yan H, Sun Y, Chen W, Chen S, et al: Complications of open elbow arthrolysis in post-traumatic elbow stiffness: a systematic review. PLoS One. 2015; 10(9): e0138547.
Kodde IF, Van Rijn J, Van den Bekerom M, Eygendaal D. Surgical treatment of post-traumatic elbow stiffness: a systematic review. J Shoulder Elbow Surg. 2013; 22: 574-80.
Wu X, Wang H, Meng C, Yang S, Duan D, Xu W, et al: Outcomes of arthroscopic arthrolysis for the post-traumatic elbow stiffness. Knee Surg Sports Traumatol Arthrosc. 2015; 23: 2715-20.
Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981; 63(6): 872–7.
Nandi S, Maschke S, Evans PJ, Lawton JN: The stiff elbow. Hand (NY). 2009; 4(4): 368-79.
Savoie III FH. Guidelines to becoming an expert elbow arthroscopist. Arthroscopy. 2007; 23(11): 1237-40.
Williamson A, Hogart B: Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005; 14(7): 798-804.
Dawson J, Fitzpatrick R, Carr A, Murray D: Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996; 78(2): 185-90.
Cikes A, Jolles BM, Farron A: Open elbow arthrolysis for posttraumatic elbow stiffness. J Orthop Trauma. 2006; 20(6): 405-9.
Gosling T, Blauth M, Lange T, Richter M, Bastian L, Krettek C: Outcome assessment after arthrolysis of the elbow. Arch Orthop Trauma Surg. 2004; 124(4): 232-6.
Park MJ, Kim HG, Lee JY: Surgical treatment of posttraumatic stiffness of the elbow. J Bone Joint Surg Br. 2004; 86: 1158-62.
Ruch DS, Shen J, Chloros GD, Krings E, Papadonikolakis A: Release of the medial collateral ligament to improve flexion in post-traumatic elbow stiffness. J Bone Joint Surg Br. 2008; 90(5): 614-8.
efo, I, Eygendaal D: Arthroscopic arthrolysis for posttraumatic elbow stiffness. J Shoulder Elbow Surg. 2011; 20(3): 434-9.
Degreef I, De Smet L: Elbow arthrolysis for traumatic arthrofibrosis. A shift towards minimally invasive surgery. Acta Orthop. Belg. 2011; 77(6): 758-64.
Pederzini LA, Nicoletta F, Tosi M, Prandini M, Tripoli E, Cossio A: Elbow arthroscopy in stiff elbow. Knee Surg Sports Traumatol Arthrosc. 2014; 22(2): 467-73.
Keener JD, Galatz LM. Arthroscopic management of the stiff elbow. J Am Acad Orthop Surg. 2011; 19(5): 265-74.
Higgs ZC, Danks BA, Sibinski M, Rymaszewski LA: Outcomes of open arthrolysis of the elbow without post-operative passive stretching. J Bone Joint Surg Br. 2012; 94(3): 348-52.