Affiliation:
1. Vreden National Medical Research Center of Traumatology and Orthopedics
Abstract
Introduction Surgical treatment of stiff elbow caused by ossification often result in poor outcomes due to anatomical and physiological characteristics, significant functional load and higher patient requirements for the elbow functionality.The purpose was to determine ways of improved surgical treatment for patients with elbow contractures caused by ossification, based on an analysis of literature reporting surgical strategy and outcomes.Material and methods An internet search of PubMed, Medline, Elibrary.ru, CyberLeninka, Google Scholar, International Clinical Trials Registry of the US National Institutes of Health, ISRCTN Registry of International Standard Randomized Clinical Trial Numbers, German Clinical Trials Registry DRKS, WHO Registry was performed. Search words and phrases included elbow contracture, ossification, surgical treatment, stiff, elbow, surgical treatment, ossification. The search depth was 10 years.Results and discussion Some important parameters (recurrence of stiffness, pain, decreased quality of life, etc.) are reported as “very unassertive” in patients with stiff elbow due to ossification at mid and long terms (12–24 months or greater). Poor outcomes are reported in approximately 50 % of the cases due to the range of motion decreased to the preoperative level or less. Many patients (more than 90 % according to some authors) need a repeated surgery and are at risk for the stiff joint.Conclusion A critical analysis of the literature indicates lack of preoperative instrumentation examination of patients with use of new visualization methods (3D modeling). Preoperative examination and surgical planning based on additive technologies are essential for surgically treated patients with stiff elbow caused by ossification.
Publisher
Russian Ilizarov Scientific Centre Restorative Traumatology and Orthopaedics
Reference59 articles.
1. Kapandzhi A.I. Physiology of joints. 6th ed. Moscow: Eksmo Publ.; 2009:368. (In Russ.)
2. An K, Zobitz ME, Morrey BF. Biomechanics of the elbow. In: Morrey BF, Sanchez-Sotelo J. (eds.) The elbow and its disorders. Philadelphia, PA: WB Saunders Publ.; 1993:39-66.
3. Ratyev AP, Skoroglyadov AB, Korobushkin GV, et al. Long-term results of treatment of patients with fracture dislocations of forearm bones. Bulletin of RSMU. 2013;(3):26-30. (In Russ.)
4. Gorshunov DE, Korolev SV. Method of prevention of complications after surgeries on the elbow joint. Patent RF, no. 2288664, 2006. Available at: https://www.fips.ru/registers-doc-view/fips_servlet. Accessed Jan 16, 2024. (In Russ.)
5. Jupiter JB. The management of nonunion and malunion of the distal humerus – a 30-year experience. J Orthop Trauma. 2008;22(10):742-750. doi: 10.1097/BOT.0b013e318188d634