The timing of open surgical release of post-traumatic elbow stiffness: A systematic review. Issue 49 (December 2017)

• Record Type: Journal Article
• Authors: Sun, Chao; Zhou, Xijie; Yao, Chenglun; Poonit, Keshav; Fan, Cunyi; Yan, Hede
• Other Names: Mayr. Johannes section editor.
• Is Part Of: Medicine. Volume 96:Issue 49(2017)
• Publication Date: 2017-12
• Subjects: complications -- open surgical release -- post-traumatic elbow stiffness -- range of motion -- systematic review -- timing; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000009121
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Background: Open release of post-traumatic elbow stiffness is effective in restoring elbow function, but there is no guideline on the optimal time point of surgical release so far. The purpose of this article was to summarize the current available literature reporting on the timing of open release of post-traumatic elbow stiffness. Methods: The PubMed, Cochrane Library, and EMBASE were searched with a set of predefined inclusion and exclusion criteria. Manual searches for references were performed to find potential relevant studies. Two authors separately extracted data from all the articles selected. Results: 27 articles published between 1989 and 2017 were included with an overall enrollment of 836 patients. We divided all included studies into 3 groups according to the timing of surgical release: group 1 (6–10 months after injury), group 2 (11–20 months after injury), and group 3(>20 months after injury). The mean postoperative Mayo Elbow Performance Score (MEPS) and recurrence rate were similar among the 3 groups; however, the mean gain in arc of motion in group 1 was the highest with the lowest complication rate among the 3 groups. Conclusion: There was a trend toward a shorter waiting time from injury to open arthrolysis from 12 months to 6 months. The shorter waiting period of 6 to 10 months yielded better results. Therefore, early surgical release of stiff elbows is recommended for a shorter rehabilitation time and earlier return to work. Level of evidence: Level IV, Systematic Review.