Clin Orthop Surg.  2009 Mar;1(1):27-33. 10.4055/cios.2009.1.1.27.

Debridement Arthroplasty for Post-traumatic Stiff Elbow: Intraoperative Factors Affecting the Clinical Results of Surgical Treatment

• Rhee YG
• Cho NS
• Lim CT
• Yi JW

• KMID: 1127911
• DOI: http://doi.org/10.4055/cios.2009.1.1.27

Abstract

BACKGROUND: This study evaluated the outcomes of debridement arthroplasty for stiff elbows, as well as the factors affecting clinical outcomes after surgical treatment.
METHODS
Eighteen patients with post-traumatic stiff elbows were treated with debridement arthroplasty using a posterior approach. The mean patient age was 33 years (range, 16 to 59 years), and the average follow-up period was 59 months (range, 24 to 141 months). The patient's ability to perform activities of daily living, including combing their hair, feeding themselves, performing hygiene, and putting on shirt and shoes, were evaluated using the Mayo Elbow Performance Score.
RESULTS
At the last follow-up, 16 elbows had painless motion. Two patients continued to complain of mild intermittent pain. The flexion and extension improved to 121degrees and 10degrees after surgery, respectively, indicating an average 34degrees increase in elbow flexion range and an average 25degrees increase in elbow extension range (p < 0.001, p < 0.001). The Mayo Elbow Performance Score at the last follow-up was excellent in nine elbows (50%) and good in nine elbows (50%).
CONCLUSIONS
Debridement arthroplasty is a predictable procedure for the treatment of intractable stiff elbow, provided that the elbow is stable and congruous.

Keyword

Elbow; Stiffness; Debridement arthroplasty

MeSH Terms

Activities of Daily Living
Adolescent
Adult
Arthroplasty/*methods
Debridement/methods
Elbow Joint/*injuries/physiopathology/*surgery
Female
Humans
Male
Middle Aged
Pain
Range of Motion, Articular
Recovery of Function
Statistics, Nonparametric
Treatment Outcome
Young Adult

Figure

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  Fig. 1 The olecranon fossa was fenestrated using an electric burr because the osteotomized tip of the olecranon had encroached on the osteophytes of the olecranon fossa.

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  Fig. 2 Anterior capsular release and coronoid excision were carried out through the hole.

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  Fig. 3 The collateral ligament was released in a patient with elbow flexion limitation.

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  Fig. 4 Passive extension motion and early overhead down exercise for flexion began one day after surgery

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