Arthrolysis for Post-traumatic Ankylosis of the Elbow

Journal of the Korean Society for Surgery of the Hand 1999;4(2):157-162.
Published online January 1, 1999.

Moon Sang Chung,Goo Hyun Baek,Jin Ho Kim,Chong Bum Chang,Woo Dong Nam,Sang Rim Kim

외상성 주관절 강직에 대한 관절 유리술

정문상,백구현,김진호,장종범,남우동,김상림

Abstract

Purpose
: In order to evaluate the effectiveness of arthrolysis for treatment of post-traumatic ankylosis of the elbow, and the factors affecting final results. Materials and Methods : We reviewed 47 cases of post-traumatic partial ankylosis of the elbow, treated by arthrolysis from September 1987 to February 1998. There were 26 males and 21 female patients with an average age of 34 (15-60) years. We performed arthrolysis including olecranonplasty (partial excision of olecranon tip) and removal of scar tissue within the olecranon fossa in order to correct flexion contracture as well as the restriction of further flexion. Residual soft tissue contracture was released by Bricement force. When sufficient range of motion was not achieved by these procedures, anterior release - capsulotomy and/or resection of bony spurs about the coronoid process - was added. Tardy ulnar nerve palsy was combined in 23 cases. We performed anterior transposition of ulnar nerve in 22 cases of them. Results : With a mean follow up of 29 (12-104) months, extension improved from an average flexion contracture of 36¡Æpreoperatively to 12¡Æpostoperatively, and average point of maximum flexion increased from 101¡Æpreoperatively to 123¡Æpostoperatively. The average arc of motion increased to 46¡Æ. Three cases showed poor results, due to severe myositis ossificans and pain. Conclusion : Olecranonplasty and Bricement force was considered as an easy and effective method for the treatment of post-traumatic ankylosis of the elbow.