Arthrolysis as secondary intervention on the elbow

Abstract

Background: The background to this study involved questions on the treatment approach to posttraumatic complaints of the elbow joint with movement restriction after elbow joint injuries. Objective: The aim of the article is to provide a summary of practical suggestions for the treatment by arthroscopic and open arthrolysis. Material and methods: Based on the diagnosis-related groups (DRG) coding system and the surgical reports, the number of arthrolyses performed in this clinic from 2011–2018 were retrospectively evaluated. Results: During this period 177 arthrolyses were performed of which 24 were carried out arthroscopically and 169 were open. In 14 cases the arthroscopy was changed to an open arthrolysis. In open arthrolysis 131 cases were combined with anesthesia mobilization and in 122 cases additional removal of free joint bodies, removal of osteophytes or ossification was performed. In 76 cases material was removed in addition to open arthrolysis and in another 75 cases neurolysis of the ulnar nerve was simultaneously carried out. In the majority of open arthrolyses isolated radial access was performed in 58 casualties or isolated dorsal access in 56 casualties. A combined access of radial/ulnar or radial/dorsal was carried out in 17 cases each. The general complication rate of open arthrolysis was 3.55%, whereas for arthroscopic arthrolysis no complications occurred. Conclusion: In this article the advantages and disadvantages of the respective procedure are discussed as well as the advantages and disadvantages of the individual access options for open arthrolysis. Furthermore, the timing of surgery and neurolysis of the ulnar nerve are discussed as well as special complications.