Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows
- PDF / 347,546 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 1 Downloads / 179 Views
ORTHOPAEDIC SURGERY
Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows Hong-jiang Ruan • Shen Liu • Cun-yi Fan Jun-jian Liu
•
Received: 8 July 2012 / Published online: 27 November 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Background An ankylosed elbow is defined as an elbow having a range of motion of 0°. Movement is extremely limited. This study retrospectively analyzes the results of arthrolysis and hinged external fixation performed on 15 patients suffering from ankylosed elbows. Methods Fifteen completely ankylosed elbows were treated by arthrolysis and hinged external fixation. Patients comprised nine men and six women, with a mean age of 37.93 years (37.93 ± 9.68) when arthrolysis was performed. Before surgery, the elbows were ankylosed at various angles ranging from 30° to 85°. Eleven patients underwent arthrolysis by medial and lateral approaches, three patients by the posterior approach, and one patient by posterior and lateral approaches. Hinged external fixators were applied to all patients. Subcutaneous anterior transposition of the ulnar nerve was performed in all patients. Result All patients received satisfactory follow-up. The range of motion of the elbow improved from 0° H.-J Ruan and S. Liu are the co-first authors H. Ruan S. Liu C. Fan (&) Department of Orthopaedics, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, People’s Republic of China e-mail: [email protected] H. Ruan e-mail: [email protected] S. Liu e-mail: [email protected] J. Liu Department of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, People’s Republic of China e-mail: [email protected]
preoperatively to a postoperative mean of 115.67° (115.67 ± 23.29). The Mayo Elbow Performance Score improved from a mean of 67.67 ± 11.00 to 86.67 ± 8.38 points, with excellent results in nine patients, good in five, and fair in one. This difference is statistically significant (t = -6.862; p \ 0.001). Conclusion Open arthrolysis and monolateral hinged external fixation are effective in treating posttraumatic ankylosed elbow. Arthrolysis should be performed by a combination of lateral and medial approaches. In addition, routine hinged external fixation and anterior transposition of the ulnar nerve may improve the postoperative recovery of elbow stiffness. Keywords Ankylosed elbow Arthrolysis Hinged external fixation Posttraumatic
Introduction Elbow stiffness following trauma or posttraumatic heterotopic ossification (HO) results in functional limitation due to the complex anatomy of the elbow, which forms a congruent hinge. Elbow stiffness can be graded according to arc of flexion [1]. A very severe stiff elbow is defined as an elbow having a total arc of less than 30°, while a severely stiff elbow has a total arc of 31°–60° and a moderately stiff elbow, 61°–90°. As it results in very severe elbow stiffness with a range of motion (ROM) of 0°, an ankylosed elbow results in extremely limi
Data Loading...
