Original ArticlesOutcome of Open Release for Post-Traumatic Elbow StiffnessTan, Virak MD; Daluiski, Aaron MD; Simic, Paul MD; Hotchkiss, Robert N. MDAuthor Information From the Division of Hand and Microsurgery, Department of Orthopaedics, University of Medicine and Dentistry of New Jersey-The New Jersey Medical School, Newark, New Jersey (V.T.); Division of Hand Surgery, Department of Orthopaedic Surgery, The Hospital for Special Surgery, New York, New York (A.D., P.S., R.N.H.). Submitted for publication December 29, 2004. Accepted for publication July 28, 2005. Presented at the American Society for Surgery of the Hand 57th Annual Meeting, Phoenix, AZ, October 5, 2002. Address for reprints: Virak Tan, MD, Department of Orthopaedics, UMDNJ, 90 Bergen Street, DOC 1200, Newark, NJ 07101-1709; email: [email protected]. The Journal of Trauma: Injury, Infection, and Critical Care: September 2006 - Volume 61 - Issue 3 - p 673-678 doi: 10.1097/01.ta.0000196000.96056.51 Buy Metrics Abstract Background: Post-traumatic elbow stiffness can be caused by a tether and/or a block, and these structures can exist both anteriorly and posteriorly about the joint to prevent motion. The purpose of this article is to report the outcome of elbow release performed for post-traumatic stiffness by a single surgeon. Methods: A retrospective review of charts and radiographs was performed on 52 case of patients who underwent open surgical treatment for post-traumatic elbow contracture by the senior author (RHN). The mean age of the group was 35.1 years. There were 32 men and 20 women. Contracture release surgery was performed at an average of 14 months from the time of injury. Indication for operative release was functional loss of elbow arc of motion that failed nonoperative therapy and splinting program. Follow-up was 18.7 months. Comparison of ranges of motion was performed with Student’s pairedt tests. Results: The average extension-flexion arc of motion improved from 57 to 116 degrees and forearm rotation improved from 119 to 145 degrees postoperatively. Fourteen patients (27%) required closed manipulation under anesthesia, in the early postoperative period. Five patients required a second contracture release at an average of 12 months after the index release. Four patients failed because of painful motion (n = 2) and elbow instability (n = 2). Other complications included wound infection (n = 3), cubital tunnel syndrome (n = 3) and reflex sympathetic dystrophy (n = 1). Conclusions: Open elbow release with excision of tethers and blocks is a valuable procedure for post-traumatic stiffness. Recurrence in postoperative period is common but is responsive to manipulation under anesthesia and repeat releases. © 2006 Lippincott Williams & Wilkins, Inc.