Post-Traumatic Elbow Contracture: Arthroscopic Release versus Mini-Incision Technique (SS-62)

Abstract

The purpose of this study was to compare the clinical outcome after complete arthroscopic release and that after open release of post-traumatic elbow contracture. A randomized study was performed in patients with post-traumatic elbow contracture but without posterior impingement and heterotopic ossification. Surgical release was performed on the anterior side of the elbow, and manual manipulation was done to overcome the other movement restriction factors. In the arthroscopy group, arthroscopic release was performed through the anteromedial portal, and the proximal and distal anterolateral portals. A working space was created between the contracted fibrous tissue and the anterior muscles. Through an outside-to-inside way, the scar tissue outside the capsule and the fibrous capsule was transected and partially removed. In the mini-incision group, a 3 cm long lateral incision was made deep to the capsule. Through blunt dissection, the anterior muscles were separated from the anterior contracted tissue. Then the contracted tissue was transected and removed with arthroscopic instruments. 24 patients in the arthroscopy group and 27 patients in mini-incision group were followed up for more than 2 years. The clinical results were evaluated. The extension increase was 28.4°±5.3° and 29.0°±5.9°, and the flexion increase were 17.8°±7.5° and 18.5°±6.9°, respectively in the arthroscopy and mini-incision group. According to the American Shoulder and Elbow Surgeons Assessment Form, satisfaction was 8.9±0.4 and 9.1±0.3 out of 10, and function was 27.9±1.0 and 28.4±0.8 out of 30. There was no statistically significant difference between the clinical outcomes of the two groups. Both arthroscopic and mini-open outside-to-inside release technique can get satisfied results.