Background
Post-traumatic elbow stiffness is a common orthopedic problem following various injuries due to late presentation and inadequate initial management. Several techniques have been proposed to treat post-traumatic elbow stiffness. Nonoperative management remains the treatment of choice. However, when functional impairment results from a loss of elbow motion that remains refractory to conservative measures, surgical treatment is indicated. The aim of this study was to compare two different techniques of elbow arthrolysis, each method constituting a method of treatment.
Patients and methods
Thirty-three patients with post-traumatic stiff elbow joints had been treated first by conservative measures for at least 6 months. The patients were divided into two groups; the first group included 18 patients with an average age of 31.05 years treated by open arthrolysis. The second group included 15 patients with an average age of 31.66 years treated by the arthroscopic method.
Results
The results were evaluated using the Mayo clinic score for elbow function and the Krishnamoorthy score. In the open group, after an average follow-up period of 19.33 months, the average Mayo clinic score improved from 63.38 to 92.83 and the average range of motion improved from 51.11° to 103.94°; 13 cases (72.22%) showed excellent results, four (22.22%) showed good results, and one case (5.55%) showed a poor result according to the Krishnamoorthy score. In the arthroscopic group, after an average follow-up period of 17.73 months, the average Mayo clinic score improved from 62.93 to 92.73, and the average range of motion improved from 59.46° to 101.53°; 10 cases (66.66%) showed excellent results, three cases (20%) showed good results, and two cases (13.33%) showed a poor result according to the Krishnamoorthy score.
Conclusion
Both open and arthroscopic treatment can be effective in the treatment of post-traumatic stiff elbows. Arthroscopic treatment is associated with less postoperative pain and morbidity. However, open treatment provides better range of motion and marked improvement of elbow function.