A Follow-up Study On Outcome Of Surgical Treatment To Post-traumatic Elbow Dysfunction

Objective：to analyze outcome of surgical treatment to post-traumatic elbow dysfunction,especially surgeries with medial and lateral approaches associated with external fixator.Methods：From Mar.2010to Sep.2012, we took surgical operations on80patients withpost-traumatic elbow dysfunction, on average11months(2-20months) after they got hurt.we removed heterotopic ossification and the hyperplastic and adhensive tissue wereresected. By the release of joint capsule and ligaments, elbow function were significantlyimproved. We instructed rehabilitation exercises and Celexoxib was used to preventrecurrence of heterotopic ossification. We use Mayo Elbow Performance Index(MEPI) toevaluate theraputic effect.Results：The follow-up period ranges from6to24months(13.8months on average), andthrough post-operative exercise, the average range of motion(ROM) of affected elbowsimproved from34.9°±32°to119.8°±25.9°, meanwhile the average rotation limitationimproved from117.4°±63.2°to147.3°±24.2°, and finally the MEPI rose to89.3±13.9fromprevious48.1±16.7. The difference was statistically significant.Conclusions：A suitable surgical management to post-traumatic elbow dysfunctionincludes arthrolysis through medial and lateral approaches, cleaning of heterotopicossification, releasing of soft tissue, using of Celexoxib and rehabilitation associated withexternal fixator. Through all this, the theraputic effect can remarkably improved. Objective：To analyze clinical related influential factors of function recovery aftersurgical treatment of post-traumatic elbow dysfunction, provide important data forefficiently preventing and treating relative diseases, help orthopaedists evaluatepathogenetic condition and choose therapeutic regimen, and finally improve elbowfunction recovery and prevent recurrence of elbow dysfunction.Methods：We retrospectively analyzed80patients of post-traumatic elbow dysfunctionwe had treated from Mar.2010to Sep.2012, collected medical records, compared Rangeof Motion(ROM), forearm rotation degree and Mayo Elbow Performance Index(MEPI)before and after operations using paired t-test or rank sum test, took Logistic regressionanalysis on factors that may influence outcome, and used non-parametric analysis to assessadditional factors. All patients accepted arthrolysis and had follow-up based on MEPI.Results： Univariate analysis indicated that at least10factors have significantcorrelationship with post-operative acceptance rate of elbow function, including age,educational status, associate cerebral trauma, heterotopic ossification, pre-operativeduration, frequency of operation, operative approach, Celecoxib application, starting timeof rehabilitation, rehabilitation program and performance. Multi factor Logistic regressionanalysis indicated that operative approach, duration of operation, Celecoxib application,starting time of rehabilitation, rehabilitation program and performance, duration of externalfixator are in sequence the independent influence factors of outcome.Conclusions：Early rehabilitation associated with Celexocib have profound importance,while other factors are also very important independent factors. Proper treatments arehelpful to elbow function recovery.