Posttraumatic Elbow Contracture

Gregory Rafijah

Disclosures

Curr Orthop Pract. 2014;25(3):213-216. 

In This Article

Outcomes

Overall, good results have been reported for open and arthroscopic contracture release of the elbow. Patients under-going open capsular release surgery can anticipate improvement of flexion and extension arcs by 45--55% or more,[27] even in high-energy combat related injuries.[28] In a study of 29 patients with elbow stiffness treated arthroscopically, a mean improvement of 341 degrees of the flexion-extension arc was maintained at an average of 15.4mo. No vascular or neurologic complications were reported in that series.[15]

Complications of surgical release of posttraumatic elbow contracture include injury to neurovascular structures, periarticular fracture, joint instability, recurrence of stiffness, and heterotopic ossification. A recent retrospective review of 177 patients treated surgically for posttraumatic elbow stiffness by a single surgeon who performed circumferential capsulectomy, heterotopic ossification excision, hardware removal, and ulnar neurolysis with transposition demonstrated significant benefit.[27] The flexion-extension arcs improved from 51° to 109°, with 69% achieving greater than a 100° degree arc of flexion-extension that was maintained at 12-month follow-up. Eight of these patients had recurrence of heterotopic ossification, with four patients requiring reoperation. Other complications included five infections, one postoperative fracture, and one hematoma.

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