Increased ROM and high patient satisfaction after open arthrolysis: a follow-up-study of 43 patients with posttraumatic stiff elbows.

Background: Posttraumatic stiffness of the elbow is a common finding after elbow trauma. Restoration of motion in the posttraumatic stiff elbow is difficult, time consuming, and requires high patient compliance. We have evaluated the long-term effect of an open elbow arthrolysis in the posttraumatic stiff elbow.

Methods: We evaluated 43 patients (14 women, 29 men) with a median age of 47(16-78) years operated with open arthrolysis for a posttraumatic stiff elbow. The median follow-up time was 41(12-204) months. The patients were hospitalized median 12(4-14) days, with daily physiotherapy and NSAID. 36 patients tolerated continuous passive motion (CPM) for 11(0-42) days. 35 patients had a well-functioning brachial plexus anesthesia for median 7(1-18) days. We used the paired 2-tailed T-test in our statistical analysis.

Results: Preoperatively the patients had a median flexion of 110(30-160)°, extension 40(10-90)°, and the total flexion-extension sector (F/E) was 50(0-110)°. At follow-up the patients had a median flexion of 132(75-151)° and extension of 23(8-84)°, which indicate a median gain of 42(-50-114)°. The subjective functional scores (Mayo Elbow Score, EQ5D, Q-Dash, and VAS for pain) were satisfying, and most of the patients (81 %) would have done the operation once again knowing the outcome. We had 5 temporary ulnar neuropraxias, one became permanent and in addition ankylotic, one temporary radial neuropraxia, two superficial wound infections, and one transient hematoma.

Conclusion: Open arthrolysis of the posttraumatic stiff elbow is associated with reliable clinical and functional long-term outcomes.