Abstract
Background. In children with arthrogryposis, a lack of elbow flexion with extensor elbow contractures limits the childs self-care.
 Aim. The aims of this study were to follow and analyze treatment results after posterior arthrolysis of the elbow joint with lengthening (Z-plasty, according to the V-Y technique) or without lengthening the triceps of the shoulder in children with arthrogryposis in different age groups.
 Materials and methods. Data from 109 patients with arthrogryposis with extensor contractures in the elbow joints (158 joints) who underwent posterior arthrolysis of the elbow joint to increase passive flexion in the elbow joint from 2005 to 2018 were included in this study. Clinical, and X-ray examination of patients was carried out.
 Results. The children were divided into nine groups depending on their age at the time of the operation and the method of surgical correction (with or without lengthening of the triceps muscle). The follow-up period in the postoperative period in the main group of patients (67.1% of cases) was 4.5 years. Good treatment results were observed in 95.83% of children younger than 3 years who did not lengthen the triceps compared with 85.56% of children of the same age who extended the triceps tendon. The amplitude of passive movements after surgery was greatest in children younger than 1 year and was greater with lengthening (104.00 16.24) than without lengthening (91.38 10.27) of the triceps tendon (p 0.001). However, in cases where lengthening of the triceps tendon was not performed, extension was less limited. Over 3 years, m. triceps br. showed satisfactory results with Z-extension and V-Y extension, increasing to 19.44% and 36.51%, respectively. Results of treatment in children older 7 than years were comparable with those of children 37 years old.
 Conclusions. In children with arthrogryposis after posterior arthrolysis of the elbow joint, receiving a passive range of motion in the elbow joint allowed the child to use adaptive mechanisms for self-care. The results of treatment with extensor elbow contracture after posterior artrolysis depended not on the elongation technique (V-Y or Z-plasty) but on the angle at which the triceps tendon was sewed, the patients age at the time the operation was performed, and the postsurgery rehabilitation of the child.
Highlights
In children with arthrogryposis, a lack of elbow flexion with extensor elbow contractures limits the child’s self-care
The children were divided into nine groups depending on their age at the time of the operation and the method of surgical correction
Good treatment results were observed in 95.83% of children younger than 3 years who did not lengthen the triceps compared with 85.56% of children of the same age who extended the triceps tendon
Summary
Цель — оценить результаты лечения разгибательных контрактур локтевых суставов после заднего артролиза локтевого сустава с удлинением (Z-образно, по V-Y-технике) и без удлинения трехглавой мышцы плеча у детей в разных возрастных группах. У детей до 3 лет, которым не проводили удлинения трехглавой мышцы, наблюдались хорошие результаты лечения в 95,83 % случаев. У детей того же возраста, которым удлиняли сухожилие трехглавой мышцы, хорошие результаты зафиксированы в 85,56 % случаев. Амплитуда пассивных движений после операции больше всего увеличивалась у детей до 1 года, однако при удлинении сухожилия трехглавой мышцы плеча больше, чем без удлинения При выполнении заднего артролиза локтевого сустава с удлинением трехглавой мышцы результат лечения зависел от угла, при котором сшивали сухожилие трехглавой мышцы плеча (при угле сшивания 150° разгибание было ограничено меньше, чем при угле 100°), возраста пациента, в котором была проведена операция, и реабилитации ребенка после операции. For citation: Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2019;7(3):
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