ABSTRACT
@#Introduction: The stiffness of elbow joint severely interferes with functional ability of upper limb. Open arthrolysis, in young active patients were reported with inconsistent results may be due to its applications in injudiciously selected cases. The objective of this study was to analyse the pathological abnormalities of stiff elbows for their classification and appropriate planning of surgical management to get maximum benefit following the arthrolysis. Methods: 98 patients of ages varied from eight to 62 (mean 23.3) years with posttraumatic stiff elbows having nonfunctional arc less than 70o of flexion predominantly extra articular contracture with maintenance of radiological congruence of humeroulnar joint of five to 26 (mean 14.65) months duration were included . The ankylosed elbows based on their clinicoradiological assessment were divided into three groups and subjected to open arthrolysis. 84 patients were clinicoradiologically evaluated during 3.2 to 10.3 (mean 6.5) years follow up. Results: The patients of Group I & II having predominantly soft tissue contractures showed overall highly satisfactory and excellent results in majority. The patients of Group III having additional periarticular new bone formation with subchondral sclerosis obtained good results. The cause and duration of contractures did not seem to influence the outcome of arthrolysis. The judicious and sequential release of contracture structure is effective to regain satisfactory to elbow motion. Conclusion: Thus, judicious preoperative selection of stiff elbow is mandatory to obtain favorable functional outcome after arthrolysis.