Abstract
We present a single-surgeon series of surgical release of post-traumatic flexion contracture of the elbow performed via a limited lateral approach. We undertook a retrospective review of patients having surgery for established post-traumatic flexion deformity of the elbow. All patients underwent anterior capsulectomy via a limited lateral approach. Patients with an intrinsic contracture also had the intra-articular lesion addressed at the time of surgery. Short-term follow-up was available from clinical review until discharge. Medium-to-longterm follow-up was conducted by telephone interview supplemented by clinical review in selected cases.
Between 1998 and 2004, 23 patients were treated surgically for established flexion contracture of the elbow. There were 15 males and 8 females with a median age of 35yrs (range 16–52yrs). In sixteen patients the contracture was not associated with damage to the joint surface (extrinsic) and in seven it was (intrinsic). The mean pre-operative deformity was 55 degrees (95%CI 49 “ 61) which was corrected at the time of surgery to 18 degrees (95%CI 12 “ 23). The mean residual deformity was 25 degrees (95%CI 20 “ 31). The difference between the pre-operative and discharge deformities was significant (Wilcoxson test p< 0.001). In the extrinsic group the mean deformity at discharge was 21 degrees (95%CI 17 “ 25) compared to 34 degrees (95%CI 19 “ 49) in the intrinsic group “ this difference was significant (Mann-Whitney U test p< 0.01). In those patients with an extrinsic contracture all elbows had a return of functional extension. One patient suffered a post-operative complication with transient dysaesthesia in the distribution of the ulnar nerve which resolved after six weeks. Surgical release of post-traumatic flexion contracture of the elbow via a limited lateral approach is a safe, reliable technique with the best results achieved in patients with an isolated extrinsic contracture.
Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, The Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
