A retrospective analysis of open release surgical treatment for post-traumatic elbow stiffness in 17 children

LI Ting; JIANG Xie-yuan; YOU Hai-feng; YANG Zheng; L Xue-min; LIU Xing-hua; ZHA Ye-jun; GONG Mao-qi; FU Gang; ZHU Zhen-hua; GUO Yuan

doi:10.3969/j.issn.2095-252X.2016.04.002

Abstract：Objective Few reports of surgical treatment of post-traumatic elbow stiffness can be found in literatur. This study aimed to analyze a consecutive case series of post-traumatic elbow stiffness only in children younger than 14 years old to explore indication, surgical technique, rehabilitation, outcome and complications. Method At a mean follow-up of 25.1 months ( range, 7 - 41 months ), 17 patients with post-traumatic elbow stiffness after open release treatment were evaluated. Pre-operatively, the average flexion was 74.1° ( range, 30° - 110° ), the average limitation of extension was 42.6° ( rang, 0° to 80° ), the average lfexion-extension range of motion was 74.1° ( range, 30° - 110° ). The average ‘Mayo Elbow Performance Score’ ( MEPS ) was 59.7 points ( range, 55 to 75 points ). Most operations were through combined approach of both lateral and medial side. Intraoperatively, we tried our best to preserve the lateral ulnar collateral ligament ( LUCL ) and anterior bundle of medial collateral ligament, which are very important to the stability of the elbow. If the elbow was not stable enough intraoperatively, we applied hinged external ifxator to lateral side of the elbow. Rehabilitation began on day 1 postoperatively.Results No patient complained of pain. They had an average of 115.3° ( rang, 60° to 130° ) of lfexion of elbow and 16.5.° ( range 0° to 40° ) to full extension. ) °, The average lfexion-extension rang of motion was 115.3° ( range, 60° - 130° ). The average MEPS was 87.5 points ( range, 55 to 95 points ).Conclusion On appropriate indication, well performed open release treatment of the elbow can achieve good result in treating post-traumatic elbow stiffness of children.