OBJECTIVE: To evaluate the surgical treatment of posttraumatic stiffness of the elbow in skeletally mature patients. METHODS: Between October 2000 and October 2007, 45 elbows of 45 patients underwent surgical treatment by the Shoulder and Elbow Surgery Group, Department of Orthopedics and Traumatology, Faculty of Medical Sciences of the Santa Casa de São Paulo. Ten patients were treated by arthroscopy and the remainder by open surgery. Minimum follow-up was six months, with an average of 22 months. Age ranged from 17 to 72 years, with a mean of 36 years and three months. Male were predominant, accounting for 60% of cases. The dominant limb was involved in 56.5% of cases. Clinical evaluation of the results was done by the criteria of the American Medical Association (AMA), modified by Bruce, the Mayo Elbow Performance Score (MEPS), and by measuring the gain of the flexo-extension arc and the final range of movement. RESULTS: According to the AMA criteria, modified by Bruce, we have obtained satisfactory results of 42.2%, in contrast to 77.8% according to the MEPS. The mean postoperative arc of flexo-extension was 106º, with a 46º mean range gain. The evaluation of the variables showed that patients with an initial flexion arc greater than 90º obtained higher end flexo-extension, and those with an initial extension less than or equal to 60º gained a greater range of motion. CONCLUSION: Surgical treatment of posttraumatic stiffness of the elbow in skeletally mature individuals was satisfactory for the MEPS, but poorly according to the AMA. We observed that patients with flexion greater than 90º preoperatively evolved with a higher arc of flexo-extension after surgical treatment, while those who had extension contracture of less than or equal to 60º gained a wider range of motion.
Elbow; Contracture; Surgery; Range of Motion; Articular; Treatment Outcome
