Open release combined with distal radius fixation and hinged external fixation in the treatment of e

Abstract

Objective: This study aims to explore the effectiveness of open and release surgery combined with distal radius fixation and hinged external fixation in the treatment of elbow stiffness.

Methods: A clinical randomized controlled study was conducted in October 2015. A total of 77 patients with elbow joint stiffness caused by trauma were randomly divided into an observation group (n=38) and a control group (n=39). The control group received traditional release surgery, while the observation group received open release surgery combined with distal radius fixation and hinged external fixation. General data, including gender, age, cause of injury, type of original injury diagnosis, time from injury to operation, preoperative flexion and extension of the elbow joint, and Mayo elbow joint function scores, were collected and compared. Functional recovery of the elbow joint was evaluated using flexion and extension measurements and the Mayo elbow function evaluation standard.

Results: The incisions of both groups healed without complications. The observation group had 1 case of nail tract infection, 2 cases of ulnar nerve symptoms, 1 case of heterotopic ossification of the elbow joint, and 1 case of moderate pain in the elbow joint. The control group had 2 cases of nail tract infection, 2 cases of ulnar nerve symptoms, and 3 cases of moderate pain in the elbow joint. At the last follow-up, the range of motion of elbow joint flexion and extension and the Mayo elbow function score in both groups significantly improved compared with before the operation (P<0.05). Furthermore, the observation group had significantly greater improvements compared to the control group (P<0.05). According to the Mayo elbow function score evaluation, the observation group had an excellent and good rate of 97.4%, while the control group had an excellent and good rate of 84.6%. However, there was no significant difference in the excellent and good rates between the two groups (P=0.108).

Open release combined with distal radius fixation and hinged external fixation for traumatic elbow stiffness can significantly improve elbow joint function and provide better results than traditional release surgery.

Elbow stiffness is a common consequence of severe trauma to the elbow joint, resulting in damage to the collateral ligament and soft tissue