Background: Elbow contracture is a recognized
sequela of traumatic and developmental elbow disorders, but little
information is available regarding the surgical treatment of elbow
stiffness in the pediatric population.
Methods: Thirty-seven patients who had had open
surgical release of an elbow contracture at a mean age of sixteen
years (range, ten to twenty years) were retrospectively studied
after a mean duration of follow-up of fifteen months (range, six
to forty-four months). The elbow contracture was posttraumatic in
twenty-eight patients. The operation consisted of a capsular release with
removal of osseous impediments to motion as necessary. No patient
had muscle or tendon-lengthening.
Results: The total arc of motion improved from a
mean of 66Â° preoperatively to a mean of 94Â° postoperatively; however,
only twenty-eight patients (76%) had an improvement of
10Â° and only seventeen (46%) achieved a functional arc
of motion of 100Â° (from 30Â° to 130Â°). Two patients lost motion after
surgery. These results are less favorable than the results of previous
studies of both pediatric and adult patients. Patients in whom the
contracture had been caused by a simple dislocation of the elbow
or an extra-articular fracture tended to have better results than
those in whom the contracture was due to other causes.
Conclusions: The results of surgical treatment of
elbow stiffness in pediatric patients are less favorable and less
predictable than those in adult patients.