Scientific Article   |    
Operative Treatment of Elbow Contracture in Patients Twenty-one Years of Age or Younger
Anthony A. Stans, MD; N. G.J. Maritz; Shawn W. O’Driscoll, MD, PhD; Bernard F. Morrey, MD
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Investigation performed at the Mayo Clinic and Mayo Foundation, Rochester, Minnesota

Anthony A. Stans, MD
Shawn W. O’Driscoll, MD, PhD
Bernard F. Morrey, MD
Mayo Clinic, 200 First Street S.W., Rochester, MN 55905

N.G.J. Maritz
Department of Orthopaedic Surgery, Pretoria Academic Hospital, Private Bag X169, Pretoria 0001, South Africa

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A video supplement to this article is available from the Video Journal of Orthopaedics. A video clip is available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

J Bone Joint Surg Am, 2002 Mar 01;84(3):382-387
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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 66° preoperatively to a mean of 94° postoperatively; however, only twenty-eight patients (76%) had an improvement of 10° and only seventeen (46%) achieved a functional arc of motion of 100° (from 30° to 130°). 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.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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