• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.72-77
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• 1998

We treated 5 elbows with post-traumatic flexion contractures (mean contracture: 51 degrees) by arthroscopic anterior capsular release and post-operative alternative flexion and extension splint. Each elbow had been resistant to at least six months of conservative therapy. An incongruent ulno-humeral articulation was considered to be a contraindication to this procedure. All patients complained of the residual deformity and some functional deficit. All patients, after failure of non-operative therapy, desired a operative treatment. At follow-up(mean 21.8 months), there was a mean post-operative contracture of 19 degrees, which is within a functional range of motion. So we conclude that arthroscopic capsular release in selected patients is reasonable alternative to open release.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.10a
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• pp.399-399
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• 2002

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.462-466
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• 2023

Surgical release of elbow contracture is associated with injury to structures traversing the elbow. To date, only one other case report has been published describing anterior interosseous nerve (AIN) palsy that developed immediately after open elbow contracture release and debridement. Here we describe the unique case of a patient that developed AIN palsy 1 week after operation, including magnetic resonance imaging and electrodiagnostic studies, to shed some light on the etiology of this rare complication.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.286-292
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• 2010

Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.242-249
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• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1999.03a
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• pp.38-40
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• 1999

$\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.

• Journal of the Korean Arthroscopy Society
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• v.9 no.1
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• pp.60-64
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• 2005

Purpose: To describe the impingement of the osteophyte between the olecranon process and olecranon fossa and to understand the effect of removing the lesion on the elbow extension in heavy workers. Materials and Methods: Arthroscopy was performed to elbow of heavy industrial workers who complained painful limitation of elbow extension.6 patients(Teases) with average age of 43 year were selected. The average ROM showed flexion contracture of $17^{\circ}$ and further flexion of $87^{\circ}$. Results: In all cases, after the operation two months follow up, mean flexion contracture improved from $17^{\circ}\;to\;2^{\circ}$ with further flexion from$87^{\circ}\;to\;122^{\circ}$. After the operation 1 year follow up, the mean flexion contracture was $3^{\circ}$ and further flexion was $113^{\circ}$. Pain relief within acquired range of motion was achieved in all cases and there was no complication in this series. Conclusion: Selective removal of the impingement bony spur for treatment of flexion contracture in the patient with chronic cumulative trauma disorder patients appear to be effective method to control pain, recover joint movement and at] ow early rehabilitation.

• Archives of Reconstructive Microsurgery
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• v.14 no.1
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• pp.63-69
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• 2005

Purpose: The purpose of this study was to analyze the clinical results after Steindler flexoplasty. Materials and Methods: We analyzed 6 cases who had nearly normal finger and wrist joint flexion function, but could not flex elbow joint actively because of upper arm type brachial plexus injury. We performed operation during the period from February 1997 to July 2003. There were 5 males and 1 female with mean age of 28 years (range: $19{\sim}51$ years) when Steindler flexoplasty was done. The average follow-up period was 3 years 11 months (range: 12 months${\sim}$7 years 4 months). We assessed active range of motion of elbow joint, muscle power and elbow function by Mayer & Green grade scale at last follow-up. We assessed how much they were favorable for Steindler flexoplasty and had improvement of upper extremity function and correction of deformity. Results: Postoperative, flexion range of elbow joint improved to average $111.7^{\circ}$ (range: $90{\sim}130^{\circ}$). $25.8^{\circ}$ (range: $15{\sim}45^{\circ}$) in flexion contracture and $16.6^{\circ}$ (range: $10{\sim}35^{\circ}$) in pronation contracture were remained. Range of motion of elbow joint improved to average $85.3^{\circ}$ (range: $45{\sim}105^{\circ}$). Flexion power of elbow joint improved to Grade 5 in all cases. Postoperatively on Mayer & Green grade scale, there were excellent in 3 cases(50%), good in 2 cases(33.3%), fair in 1 case(16.7%). On patient's own assessment of functional improvement, there were excellent in 4 cases(66.6%), good in 1 case(16.7%) and fair in 1 case(l6.7%). Conclusion: Steindler flexoplasty can reserve good clinical results with being improved to active flexion of elbow joint in cases who have functional hand and wrist, but paralysis upper arm muscle in brachial plexus injury.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.176-180
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• 2005

The Outerbridge-Kashiwagi (O-K) procedure is one of popular procedures for the treatment of osteoarthritis of the elbow. Although reliable outcome has been reported in the literature, intraoperative and postoperative complications may occur. Acute postoperative neurologic complications are rarely reported in the literature. We report a case of acute complete ulnar neuropathy following O-K procedure in the elbow with longstanding flexion loss. Prophylactic ulnar nerve decompression during the O-K procedure should be considered in the elbows with osteoarthritis and prolonged severe flexion contracture.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.116-119
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• 2001

Purpose : To describe long-term clinical results and serial changes in the postoperative range of motion(ROM) after arthroscopic treatment for a limitation of motion(LOM) of the elbow. Materials and Methods : The subjects who visited chosun university hospital from December, 1996 to January 2000 were twenty-one patients ranging from 37 to 54 years of age, and the average age was 43.2 years. The chief complaints were painful limitation of motion of the elbow and average ROM showed that flexion contracture were 17 degrees and further flexion were 87 degrees. Results : The total ROM was $70^{\circ}$ preoperatively. 2 months after postoperatively the mean flexion contracute improved from $17^{\circ}\;to\;3^{\circ}$ with further flexion from $87^{\circ}\;to\;122^{\circ}$ degrees. One year after postoperatively the mean flexion contracture were $5^{\circ}$ and further flexion were $113^{\circ}$. All patients reported a decresement in pain level as well as improvement in motion. There was no complication in this series. Conclusion : Arthroscopic surgery appear to be satisfactory management modality for degenerative elbow contractures.