Intra-articular Olecranon Osteotomy and Adhesiolysis for Treatment of Post-traumatic Elbow Stiffness.

Introduction: Loss of motion is common in elbow trauma. Restoration of joint motion in post-traumatic stiff elbow can be a difficult, time consuming, and costly. We report a case of post-traumatic elbow stiffness treated with intra articular olecranon osteotomy and adhesiolysis.

Case Presentation: A 30-year-old female, with right dominant upper extremity, presented 13 months after operated well aligned right intra articular distal humerus fracture with right elbow stiffness. She had a fixed flexion deformity of 20 degrees with flexion arc of 20-30 degrees and completely free supination and pronation. She was unable to perform the activities of daily living with affected right upper extremity. Intra-articular chevron olecranon osteotomy and adhesiolysis were done for the post-traumatic elbow stiffness. Immediate post-operative active and active assisted motion exercises of elbow joint were started. Indwelling infra clavicular catheter with continuous Ropivacaine infusion was kept for analgesia. At 6 month post-operative follow-up, she achieved 10-110 degree elbow flexion arc with completely free supination and pronation. She is able to perform the daily living activities with right upper extremity.

Conclusion: Many different methods of treating post traumatic stiff elbow have been described, intra articular olecranon osteotomy helps in addressing intrinsic and extrinsic pathology with better results.