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Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

An ankylosed elbow is defined as an elbow having a range of motion of 0°. Movement is extremely limited. This study retrospectively analyzes the results of arthrolysis and hinged external fixation performed on 15 patients suffering from ankylosed elbows.

Methods

Fifteen completely ankylosed elbows were treated by arthrolysis and hinged external fixation. Patients comprised nine men and six women, with a mean age of 37.93 years (37.93 ± 9.68) when arthrolysis was performed. Before surgery, the elbows were ankylosed at various angles ranging from 30° to 85°. Eleven patients underwent arthrolysis by medial and lateral approaches, three patients by the posterior approach, and one patient by posterior and lateral approaches. Hinged external fixators were applied to all patients. Subcutaneous anterior transposition of the ulnar nerve was performed in all patients.

Result

All patients received satisfactory follow-up. The range of motion of the elbow improved from 0° preoperatively to a postoperative mean of 115.67° (115.67 ± 23.29). The Mayo Elbow Performance Score improved from a mean of 67.67 ± 11.00 to 86.67 ± 8.38 points, with excellent results in nine patients, good in five, and fair in one. This difference is statistically significant (t = −6.862; p < 0.001).

Conclusion

Open arthrolysis and monolateral hinged external fixation are effective in treating posttraumatic ankylosed elbow. Arthrolysis should be performed by a combination of lateral and medial approaches. In addition, routine hinged external fixation and anterior transposition of the ulnar nerve may improve the postoperative recovery of elbow stiffness.

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Authors and Affiliations

  1. Department of Orthopaedics, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, 600 Yishan Road, Shanghai, 200233, People’s Republic of China

    Hong-jiang Ruan, Shen Liu & Cun-yi Fan

  2. Department of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, 200072, People’s Republic of China

    Jun-jian Liu

Authors
  1. Hong-jiang Ruan
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  2. Shen Liu
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  3. Cun-yi Fan
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  4. Jun-jian Liu
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Corresponding author

Correspondence to Cun-yi Fan.

Additional information

H.-J Ruan and S. Liu are the co-first authors

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Ruan, Hj., Liu, S., Fan, Cy. et al. Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows. Arch Orthop Trauma Surg 133, 179–185 (2013). https://doi.org/10.1007/s00402-012-1659-4

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  • DOI: https://doi.org/10.1007/s00402-012-1659-4

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