The Effect Of Open Release On Elbow Traumatic Arthritis

Objective: Elbow stiffness is often complicated with traumatic arthritis.Open release is commonly used in clinic treatment of elbow stiffness.This study analyzes the effect of open release on traumatic arthritis in elbow stiffness cases,and investigates the possible influence factors of postoperative traumatic arthritis,aiming to provide clinical evidence and advice of prevention,treatment and prognosis of traumatic arthritis which is complicated with elbow stiffness.Methods: Retrospective study was performed to analyze 50 patients who had elbow stiffness and received open release combined with hinged external fixation treatment.After the operation,celecoxib was taken for 6 weeks and functional rehabilitation got started with the help of hinged external fixation.The elbow motion and level of pain were measured.Mayo Elbow Performance Score(MEPS)was used to evaluate efficacy.Kellgren Lawrence Arthrosis grade on X-ray(K-L)was used to evaluate traumatic arthritis.Comparisons were made between preoperative indicators and the postoperative ones.We took the Logistic regression analysis on factors that may influence postoperative K-L.Results: The average elbow range of motion(ROM)increased from preoperative 39.4°±12.3° to postoperative 127.4°±21.3°,meanwhile the average rotation limitation improved from preoperative 128.6°±24° to postoperative 175.6°±25°,and the average MEPS increased from preoperative 53.9±15.85 to postoperative 94.7±16.32.The percentage of painful patients was down from preoperative 54%(34% moderate,20% severe)to 22%(22% moderate).The preoperative amounts of patients classified with K-L were 34(grade 0~2),16(grade 3~4),while the postoperative ones were 44(grade 0~2),6(grade 3~4).Compared with the preoperative K-L,the postoperative one improved significantly.Multi-factor Logistic regression analysis indicated that age,preoperative duration,past therapeutic methods,preoperative maximum extension,preoperative maximum flexion,preoperative ROM,preoperative rotation limitation,preoperative MEPS,operative approach are independent influence factorsof postoperative K-L(P<0.05).Preoperative duration,preoperative maximum extension,preoperative maximum flexion,preoperative MEPS have significant correlation with postoperative K-L(P<0.001).Conclusions: The open release on patients with elbow stiffness is beneficial to reduce joint pain and relieve traumatic arthritis.Early open release which performed with combined operative approach makes a better outcome of traumatic arthritis.Age,past therapeutic methods and preoperative function of the elbow are valuable for prognosis judgment of postoperative traumatic arthritis.