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Surgical Treatment of Post-traumatic Elbow Stiffness by Wide Posterior Approach.
Gracitelli, Mauro E C; Guglielmetti, César L B; Botelho, Caio A S; Malavolta, Eduardo A; Assunção, Jorge H; Ferreira Neto, Arnaldo A.
Afiliación
  • Gracitelli MEC; Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Guglielmetti CLB; Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Botelho CAS; Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Malavolta EA; Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Assunção JH; Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Ferreira Neto AA; Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ortop (Sao Paulo) ; 55(5): 570-578, 2020 Oct.
Article en En | MEDLINE | ID: mdl-33093721
Objective To demonstrate the clinical outcomes and complication rates of the surgical release with a single posterior approach in the treatment of post-traumatic elbow stiffness. Methods A prospective study with patients submitted to surgery between May 2013 and June 2018 in a single center. The access to the elbow was made through the posterior approach. The patients were followed up by an occupational therapy team, and were submitted to a standardized rehabilitation protocol, with static progressive orthoses and dynamic orthoses. The primary outcome was the range of flexion-extension of the elbow after 6 months. Results A total of 26 patients completed the minimum follow-up of 6-months. The mean range of flexion-extension of the elbow at the end of 6 months was of 98.3 ± 22.0°, with an amplitude gain of 40.0 ± 14.0° in relation to the pre-operative period ( p < 0.001). The average flexion-extension gain at the end of 6 months was of 51.7% ± 17.1% ( p < 0.001). The mean pronosupination at the end of 6 months was of 129.0 ± 42.7° ( p < 0.001). Half of the cases had moderate and severe stiffness in the pre-operative period, compared with 7.7% at 6 months post-operatively ( p < 0.001). The mean score for the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) instruments was 74.4 ± 16.8 points and 31.7 ± 21.9 points respectively ( p < 0.001 for both). The visual analogue scale (VAS) score presented no statistically significant difference compared to the pre-operative period ( p = 0.096). Complications were observed in 6 (23%) patients, and no new surgical procedures were necessary. Conclusions The surgical release of the elbow associated with a rehabilitation protocol is a safe technique, with satisfactory results and low rate of complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Idioma: En Revista: Rev Bras Ortop (Sao Paulo) Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Idioma: En Revista: Rev Bras Ortop (Sao Paulo) Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Alemania