Randomized trial for the treatment of post-traumatic elbow stiffness: surgical release vs. rehabilitation
| Autor: | Jorge Henrique Assunção, Fernando Brandão Andrade-Silva, Mariana Miranda Nicolosi Pessa, Arnaldo Alcover Neto, Maria Candida Luzo, César L.B. Guglielmetti, Mauro Emilio Conforto Gracitelli, Eduardo Angeli Malavolta |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Visual analogue scale Elbow stiffness medicine.medical_treatment Elbow Continuous passive motion law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Elbow Joint Medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures Range of Motion Articular Physical Therapy Modalities 030222 orthopedics Rehabilitation business.industry 030229 sport sciences General Medicine musculoskeletal system Surgery body regions medicine.anatomical_structure Treatment Outcome Female Joint Diseases business Complication Range of motion Follow-Up Studies |
| Zdroj: | Journal of shoulder and elbow surgery. 29(8) |
| ISSN: | 1532-6500 |
| Popis: | Background There are no previous randomized trials comparing surgical to conservative treatment for post-traumatic elbow stiffness. The aim of our study was to compare elbow range of motion (ROM) and clinical outcomes among patients undergoing surgical treatment or a standardized rehabilitation for post-traumatic elbow stiffness. Methods Randomized clinical trial of patients with post-traumatic elbow stiffness for more than 6 months who failed conventional physical therapy for 4 months. Patients were randomized into 2 treatment groups. The conservative group underwent the rehabilitation protocol associated with the use of orthoses (static progressive for extension and dynamic for flexion) and continuous passive motion. The surgical group underwent surgical release by a posterior approach without triceps detachment, followed by a rehabilitation protocol similar to the conservative group. The primary outcome of the study was flexion-extension ROM at 6 months of follow-up. Secondary outcomes included the visual analog scale for pain, the Mayo Elbow Performance Score, the Disabilities of the Arm, Shoulder, and Hand score, absolute and relative increase in flexion-extension ROM, and complication rates. Results Thirty patients were analyzed in the study, 15 in each group. The mean elbow flexion-extension ROM at the end of 6 months of follow-up was 108° in the surgical group and 88° in the conservative group (P = .002). The mean absolute and the relative increase of elbow flexion-extension at 6 months were, respectively, 17° and 27% in the conservative group and 41° and 59% in the surgical group (P Conclusion Surgical elbow release associated with the rehabilitation protocol resulted in a greater flexion-extension ROM, as well as a greater absolute and relative increase compared with rehabilitation alone at 6 months of follow-up. The groups did not differ regarding clinical scores and complication rates. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect