The Journal of Bone and Joint Surgery, Vol 67, Issue 8 1160-1164, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Correction of post-traumatic flexion contracture of the elbow by anterior capsulotomy
JR Urbaniak, PE Hansen, SF Beissinger and MS Aitken
Despite prolonged conservative therapy, including splinting, bracing, and
supervised exercise programs, significant flexion contracture of the elbow
after local trauma may remain both a functional and a cosmetic impairment.
We studied the cases of fifteen patients who underwent a relatively limited
surgical procedure consisting of anterior capsulotomy of the elbow without
tenotomy of the biceps tendon or myotomy of the brachialis muscle. The mean
preoperative flexion deformity of 48 degrees was reduced to a mean
postoperative deformity of 19 degrees (a 61 per cent improvement). Two
groups of patients were identified. Eleven patients who did not have
significant preoperative evidence of intra-articular degenerative
(post-traumatic) changes in the joint achieved a 65 per cent improvement in
extension, with one patient having continued pain with vigorous activity.
Four patients who had significant preoperative post-traumatic arthrosis
achieved a 50 per cent improvement in extension; however, three of these
four patients continued to have significant pain. Limited anterior
capsulotomy is a safe and effective means of decreasing post-traumatic
flexion contracture of the elbow in properly selected patients. Better
overall results are obtained in elbows without significant post-traumatic
arthrosis.
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