Current state of the treatment problem in the patients with elbow joint contractures due to ossification

Abstract

Introduction Surgical treatment of stiff elbow caused by ossification often result in poor outcomes due to anatomical and physiological characteristics, significant functional load and higher patient requirements for the elbow functionality. The purpose was to determine ways of improved surgical treatment for patients with elbow contractures caused by ossification, based on an analysis of literature reporting surgical strategy and outcomes. Material and methods An internet search of PubMed, Medline, Elibrary.ru, CyberLeninka, Google Scholar, International Clinical Trials Registry of the US National Institutes of Health, ISRCTN Registry of International Standard Randomized Clinical Trial Numbers, German Clinical Trials Registry DRKS, WHO Registry was performed. Search words and phrases included elbow contracture, ossification, surgical treatment, stiff, elbow, surgical treatment, ossification. The search depth was 10 years. Results and discussion Some important parameters (recurrence of stiffness, pain, decreased quality of life, etc.) are reported as “very unassertive” in patients with stiff elbow due to ossification at mid and long terms (12–24 months or greater). Poor outcomes are reported in approximately 50 % of the cases due to the range of motion decreased to the preoperative level or less. Many patients (more than 90 % according to some authors) need a repeated surgery and are at risk for the stiff joint. Conclusion A critical analysis of the literature indicates lack of preoperative instrumentation examination of patients with use of new visualization methods (3D modeling). Preoperative examination and surgical planning based on additive technologies are essential for surgically treated patients with stiff elbow caused by ossification.

Keywords

• elbow joint
• contracture
• ossification
• surgical treatment
• arthroscopy
• manipulation under anesthesia/redressal
• prosthetics
• reconstructive plastic surgery
• long-term results