Elbow contracture release

Abstract

: The elbow joint has a high propensity for stiffness, therefore surgical management is commonly required to provide functional range of motion. Treatment should aim to address any extrinsic or intrinsic cause for the restricted elbow range of motion and the overall management should be individualized based on the etiology for stiffness, patient’s age and functional demands. The main goal of surgical release is to provide a functional elbow range of motion. Several surgical techniques have been recommended for the release of a contracted elbow including arthroscopic or open release procedures. Open release can be performed with an anterior, posterior, lateral, medial approach or a combination of a medial and lateral approach to address all relevant pathology. Ulnohumeral Arthroplasty or Outerbridge - Kashiwagi procedure can be performed either open or arthroscopically in patients with mild or moderate elbow osteoarthritis or posttraumatic arthritis. Following surgical management, rehabilitation program and dynamic splinting should be performed, usually for at least 3 months postoperatively for optimal functional results. Although satisfactory results have been reported with arthroscopic or open release procedures, each surgical technique has its own advantages and disadvantages. The optimal approach is still debatable and further study is necessary with prospective comparison trials to determine the relative risks, benefits, and outcomes of each technique.