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O2104 MOBILISATION OF STIFF ELBOW WITH EXTERNAL FIXATOR



Abstract

Aims: To treat posttraumatic stiffness of elbow by distraction arthrodiastasis and mobilisation. Standard operative procedures were combined for 4 patients with bony blocks due to myositis ossiþcans. Methods: We reviewed 8 patients, 5:M, 3:F aged 20–42 years. 3 x 2.5mm k-wires were passed in lower-third humerus from lateral to medial side and 3 x 2.5mm k-wires in proximal ulna. Distractors were applied on anterior and posterior aspect of elbow and hinge-joint at the level of elbow-joint. Elbow was gradually distracted to achieve arthro-diastatic state of joint. Maintaining arthrodiastatic state now elbow deformity is gradually corrected by distracting anterior distractors. Than distractors and hinge are locked for tissue reaction to subside over 2–3 weeks followed by dynamic mobilization. Movement gradually improves over 2–3weeks (sometimes prolonged in severe cases). Than þxator is removed and appropriate dynamic splint is applied to maintain correction while allowing mobility. In 4cases bone block was removed surgically and followed by distraction arthrodiastatic procedure. No steroid in any form was used in any stage of treatment. Results: Average follow-up: 2years (maximum 4years). All elbows were stable and extension increased by 30û and ßexion increased by 50û. One case had minor pin-tract infection, responded to basic treatment. No neurovascular deþcit was not seen post procedure in any patients. Conclusion: This technique may be considered before arthrolysis is undertaken for stiff elbow.

Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.