Intra articular olecranon osteotomy and adhesiolysis for treatment of post traumatic elbow stiffness

Vol 3 | Issue 1 | Jan-Jun 2016 | page:1-4  | Harshad L. Adhav, Rajendra Y. Nehete, Anita R. Nehete


Authors: Harshad L. Adhav [1], Rajendra Y. Nehete [2], Anita R. Nehete [3].

[1] Department of Orthopaedics, Vedant hospital, Nashik, Maharashtra, India.
[2] Department of Plastic surgery, Vedant hospital, Nashik, Maharashtra, India
[3] Department of Anaesthesia, Vedant hospital, Nashik, Maharashtra, India.

 

Address of Correspondenc
Dr. Harshad L. Adhav,
Department of Orthopaedics, Vedant hospital,
Nashik, Maharashtra, India
Email: orthosurg99@gmail.com


Abstract

Loss of motion is common in elbow trauma. Restoration of joint motion in post traumatic stiff elbow can be a difficult, time consuming and costly challenge.
We report a case of post traumatic elbow stiffness treated with intra articular olecranon osteotomy and adhesiolysis. A 30 years female with right dominant upper extremity, presented 13 months after operated well aligned right intra articular distal humerus fracture with right elbow stiffness. She had a fixed flexion deformity of 20 degrees with flexion arc of 20 to 30 degrees and completely free supination and pronation. She was unable to perform the activities of daily living with affected right upper extremity. Intra articular chevron olecranon osteotomy and adhesiolysis was done for the post traumatic elbow stiffness. Immediate post-operative active and active assisted motion exercises of elbow joint were started. Indwelling infra clavicular catheter with continuous Ropivacaine infusion was kept for analgesia. 6 months post-operative she achieved 10 to 120 degree elbow flexion arc with completely free supination and pronation. She is able to perform the daily living activities with right upper extremity. Many different methods of treating post traumatic stiff elbow have been described, intra articular olecranon osteotomy helps in addressing intrinsic and extrinsic pathology with better results.
Keywords: Adhesiolysis, elbow stiffness, intra articular, olecranon osteotomy, post traumatic.


References

1. Morrey BF, Askew LJ, Chao EY, A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am.
1981; 63(6):872-877.
2. Søjbjerg JO, The stiff elbow. Acta Orthop Scand. 1996; 67(6):626-631.
3. Geraldo Motta Filho1, Marcus Vinícius Galvão2 Post- traumatic stiffness of elbow. Rev Bras Ortop. 2010;45(4):347-356
4. Morrey BF. The posttraumatic stiff elbow. Clin Orthop Relat Res. 2005 ;(431):26-35.
5. Jupiter JB, O’Driscoll SW, Cohen MS. The assessment and management of the stiff elbow. Instr Course Lect. 2003;52:93-111.
6. Kay NR. Arthrolysis of the posttraumatic stiff elbow. In: Stanley D, Kay NR, editors. Surgery of the elbow: practical and scientific aspects. London: Edward Arnold; 1998. p. 228- 234
7. Bonutti PM, Windau JE, Ables BA, Miller BG. Static progressive stretch to reestablish elbow range of motion. Clin Orthop Relat Res. 1994;(303):128-134.
8. Duke JB, Tessler RH, Dell PC. Manipulation of the stiff elbow with patient under anesthesia. J Hand Surg Am. 1991;16(1):19-24.
9. Marti RK, Kerkhoffs GM, Maas M, Blankevoort L. Progressive surgical release of a posttraumatic stiff elbow. Technique and outcome after 2-18 years in 46 patients. Acta Orthop Scand. 2002;73(2):144-150.
10. Ball CM, Meunier M, Galatz LM, Calfee R, Yamaguchi K. Arthroscopic treatment of post-traumatic elbow contracture. J Shoulder Elbow Surg. 2002;11(6):624-629.
11. Urbaniak JR, Hansen PE, Beissinger SF, Aitken MS. Correction of post-traumatic flexion contracture of the
elbow by anterior capsulotomy. J Bone Joint Surg Am. 1985;67(8):1160-1164.
12. Mansat P, Morrey BF. The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J
Bone Joint Surg Am. 1998;80(11):1603-1615.
13. Cohen MS, Hastings H 2nd. Post-traumatic contracture of the elbow. Operative release using a lateral collateral
ligament sparing approach. J Bone Joint Surg Br. 1998;80(5):805-812.
14. Morrey BF. Post-traumatic contracture of the elbow. Operative treatment, including distraction arthroplasty. J
Bone Joint Surg Am. 1990;72(4):601-618.
15. Kelly EW, Morrey BF, O’Driscoll SW. Complications of elbow arthroscopy. J Bone Joint Surg Am. 2001;83(1):25-


How to Cite this Article: Intra articular olecranon osteotomy and adhesiolysis for treatment of post traumatic elbow stiffness. Adhav H L, Nehete R Y, Nehete A R. Journal of Orthopaedic and Rehabilitation 2016 Jan-Apr; 3(1):1-4

 (Abstract)      (Full Text HTML)      (Download PDF)


.