Grading of functional results of elbow joint arthrolysis after fracture treatment

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.