ObjectiveTo review the research progress of complications associated with open elbow arthrolysis so as to provide clinical reference for complication prevention and treatment. MethodsThe recent publications on open elbow arthrolysis and complications associated with it were extensively reviewed and analyzed. ResultsComplications associated with open elbow arthrolysis include ulnar nerve symptom and neuropathy, elbow instability, heterotopic ossification, and hematoma. Although some progress has been made in the complication prevention and treatment recently, there are still some challenges in the control of surgical trauma, intervention of heterotopic ossification and elbow instability after surgery, as well as postoperative analgesia due to the limitation of surgical techniques and the uncertain mechanism of these complications. ConclusionOpen elbow arthrolysis is safe and effective for elbow stiffness. However, more research on the mechanism of complications should be carried out, to further improve the overall effect of the surgery.
ObjectiveTo explore the effectiveness and safety of open arthrolysis combined with internal fixator removal for post-traumatic elbow stiffness. MethodsA retrospective analysis was made on the data of 80 cases treated by open arthrolysis for elbow stiffness between January 2010 and December 2011. The patients were divided into 2 groups:no internal fixation group (group A, n=39) and internal fixation group (group B, n=41) according to whether they underwent internal fixator removal at the same time. No significant difference was found in age, gender, affected side, injury time, elbow rigidity grade, and severity of heterotopic ossification (HO) between 2 groups (P>0.05) except for original injury type (P<0.05). The effectiveness was evaluated by the occurrence of complications including ulnar nerve symptoms, HO recurrence and re-fracture, the elbow range of motion (ROM) and the Mayo elbow performance score (MEPS). ResultsThe mean follow-up duration was 15.7 months (range, 12-18 months) in group A and 16.1 months (range, 12-20 months) in group B. Ulnar nerve symptoms in 5 cases (12.8%) and HO reccurrence in 1 case (2.6%) occurred in group A, while ulnar nerve symptoms in 4 cases (9.8%), HO recurrence 1 case (2.4%), and refracture in 1 case (2.4%) occurred in group B. The incidence of each complication showed no significant difference between 2 groups (P>0.05). Both the ROM and the MEPS at last follow-up increased significantly when compared with preoperative ones in 2 groups (P<0.05). Besides, MEPS of group A was significantly higher than that of group B (t=2.36, P=0.02), but no significant difference was found in the ROM between 2 groups at last follow-up (t=0.40, P=0.69). Based on MEPS, the results were excellent in 16 cases, good in 16 cases, fair in 6 cases, and poor in 1 case in group A with an excellent and good rate of 82.1%;the results were excellent in 10 cases, good in 25 cases, fair in 4 cases, and poor in 2 cases in group B with an excellent and good rate of 85.4%. There was no significant difference in excellent and good rate between 2 groups (χ2=0.16, P=0.69). ConclusionOpen elbow arthrolysis combined with internal fixator removal for post-traumatic elbow stiffness is safe and effective. However, measures for prevention of re-fracture should always be taken into consideration.