Related Factors And Prevention Strategy Of The Complications After Open Elbow Arthrolysis

Objective Ulnar neuritis(UN),heterotopic ossification(HO)and infection are common complications of open elbow arthrolysis for elbow stiffness.The purpose of this study was to evaluate the effect of prevention strategy of these complications,and to describe the related factors.Methods We retrospectively review patients with post-traumatic elbow stiffness who underwent open elbow arthrolysis in our hospital.In the part of UN,we choose patients undergoing ulnar nerve subcutaneous transposition during arthrolysis.In the part of HO,patients are divided into celecoxib group and no-celecoxib group according to whether they have taken celecoxib after surgery.In the part of infection,patients are divided into control group and vancomycin group according to whether vancomycin powder was applied directly into the wound before closure during the operation.Patient demographics,clinical characteristics,prevention strategy and incidence of UN,HO and infection are recorded.Factors associated with the complications are analysed.Results According to the follow up,9.2% of the patients had UN.The Dellon's Grade of patients associated with UN at last follow-up improved significantly compared with that preoperatively(P=0.039).Statistics analysis showed that male sex,limited preoperative flexion and arc of motion(AOM),preoperative HO,and preoperative ulnar nerve symptoms were significantly associated with the development of UN.HO was both more common and more severe in the no-celecoxib group than in the celecoxib group after surgery.Logistic regression analysis showed that taking celecoxib was the protective factor for HO recurrence,while overweight(BMI > 25)and male gender were the risk factors.2 infections occurred in the vancomycin group(1.1%),while 5 infections occurred in the control group(7.0%),which showed a significant difference(P =0.020).Operative time,history of prior surgery and preoperative range of motion seem to be associated with infection.Conclusions In order to reduce the incidence of postoperative complications and ensure the efficacy and safety of open elbow arthrolysis,adequate evaluation is needed to screen the patients with risk factors and to perform related prevention strategy for them.