Use of a modified Outerbridge-Kashiwagi procedure for the treatment of posttraumatic elbow sequelae.

Autor: Brewley EE; Florida Orthopaedic Institute, Tampa, FL, USA., Gorman RA 2nd; Foundation for Orthopaedic Research & Education, Tampa, FL, USA., Christmas KN; Foundation for Orthopaedic Research & Education, Tampa, FL, USA., Simon P; Foundation for Orthopaedic Research & Education, Tampa, FL, USA; Department of Orthopaedics and Sports Medicine, Morsani College of Medicine, Tampa, FL, USA., Chapel RJ; Florida Orthopaedic Institute, Tampa, FL, USA., Mighell MA; Florida Orthopaedic Institute, Tampa, FL, USA. Electronic address: mmighell@floridaortho.com.
Jazyk: angličtina
Zdroj: Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2019 Jul; Vol. 28 (7), pp. 1387-1394. Date of Electronic Publication: 2019 Apr 13.
DOI: 10.1016/j.jse.2019.02.002
Abstrakt: Background: To review our 10-year experience treating posttraumatic sequelae of the elbow using a modified Outerbridge-Kashiwagi (O-K) procedure.
Methods: Twenty-one patients with posttraumatic sequelae of the elbow treated using the technique were evaluated clinically using the Mayo Elbow Performance Score, range of motion testing, and pain level. We noted the presence of preoperative and postoperative ulnar nerve symptoms, complications, and reoperations. Open contracture release was selected to address either removal of hardware or ulnar nerve pathology.
Results: At a mean of 39 months (range, 12-116 months), the Mayo Elbow Performance Score improved from 52 to 84 (P < .0001) and the mean arc of motion improved from 44° to 98° (P < .0001). At the final follow-up, 90% of patients reported no pain or mild pain, and 81% of patients had a satisfactory objective result. In 15 of 21 cases (71%), it was necessary to mobilize the ulnar nerve. After contracture release, 1 patient developed new onset ulnar nerve symptoms. Three patients underwent reoperation: 2 for recalcitrant contracture and 1 for new onset ulnar nerve symptoms.
Conclusions: The mini-open O-K procedure is safe and effective in restoring function in patients with retained hardware and posttraumatic contracture. Posttraumatic arthritic patients often require both removal of hardware and neurolysis of the ulnar nerve. The mini-open O-K procedure allows complete access to the elbow joint, which facilitates release for both intrinsic and extrinsic contracture.
(Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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