Comparison of the clinical outcomes of stiff elbow release via combined lateral and medial approach and via posterior median approach

Abstract

Objective To evaluate and compare the clinical outcomes of stiff elbow release via combined lateral and medial approach and via posterior median approach. Methods Arthrolysis was performed in 44 cases with stiff elbow. Combination of lateral and medial approach was carried out in 22 cases. The posterior capsule was excised and the olecranon fossa was debrided through the medial approach. The anterior capsule was excised and the radial head was debfided through the lateral approach. The posterior median approach was carried out in the other 22 cases. The olecranon fossa was debridod after detachment of triceps insertion. Exposure of the deep structures on both sides of the joint was achieved by dissection via intermuscular septums. Results All patients were followed up for a mean 23.2 months (ranged from 14 to 52 months). The mean range of motion of the elbow joint in patients treated with combined lateral and medial approach was (108.0±12.4)°, while the mean Mayo Elbow Score was (83.4±2.4). The mean range of motion in patients with posterior median approach was (95.7±17.3)°, while the mean Mayo Elbow Score was (79.2±6.9). The clinical results of the two groups were statistically different (P<0.01). Range of motion and the Mayo Elbow Score between the two groups showed statistically significant differences (P<0.05). Conclusion Surgical release of stiff elbow via combined lateral and medial approach and via posterior median approach is safe and effective. Combined lateral and medial approach leads to better clinical outcomes than the posterior median approach. Key words: Elbow joint; Treatment outcome; Joint stiffness