In the treatment of posttraumatic contracture of the elbow joint, arthrolys
is is a proven procedure. We used a stepwise operative approach starting la
terally and including an additional medial and dorsal incision if needed. A
total of 91 patients with arthrolysis of the elbow could be followed-up on
average 44 months (range 9-102 months) joint after operative (58, 63.7%) a
nd nonoperative (33, 36.3%) fracture treatment. The mean preoperative range
of motion (ROM) in flexion/extension was 49 degrees (SD +/- 38 degrees), w
hile in pronation/supination it was 89 degrees (SD +/- 66 degrees). Postope
ratively, the ROM was on average 94 degrees (SD +/- 27 degrees) in flexion/
extension and 129 degrees (SD +/- 52 degrees) in pronation/supination. Usin
g our own grading system, it became evident that most patients had a functi
onal benefit from the procedure, although the quality of the improvement di
ffered. For example, postoperatively 59.3% of the patients were grade I (gr
eater than or equal to 90 degrees) in flexion/extension compared with 16.5%
preoperatively. Although the rest also showed improvements, their function
al benefit was less. The earlier the release of the joints was performed, t
he better was the functional outcome (p < 0.05), The importance of an inten
sive early rehabilitation programme is emphasised while indications for thi
s procedure should Only be seen in compliant patients.