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Treatment of the Stiffness of the Elbow using Posterior Extensile Approach

광범위 후방 접근법을 이용한 주관절 강직의 치료

  • Yoo Chong-Il (Department of Orthopaedic Surgery, College of Medicine, Pusan National University) ;
  • Kim Hui-Taek (Department of Orthopaedic Surgery, College of Medicine, Pusan National University) ;
  • Son Kyo-Min (Department of Orthopaedic Surgery, College of Medicine, Pusan National University) ;
  • Ku Jeong-Mo (Department of Orthopaedic Surgery, Pusan Medical Center) ;
  • Jung Chul-Yong (Department of Orthopaedic Surgery, Pusan Medical Center)
  • 유총일 (부산대학교 의과대학 정형외과학교실) ;
  • 김휘택 (부산대학교 의과대학 정형외과학교실) ;
  • 손교민 (부산대학교 의과대학 정형외과학교실) ;
  • 구정모 (부산의료원 정형외과학교실) ;
  • 정철용 (부산의료원 정형외과학교실)
  • Published : 2005.06.01

Abstract

Purpose: To review the surgical results of stiff elbow using the posterior extensile approach which provides a wide surgical view with a single posterior skin incision. Materials and Methods: From February 1999 to May 2002, we performed 6 surgical correction of stiff elbow using posterior extensile approach and followed the patients more than 1 year. In order to get better result, we performed cadaver study (four elbows of two fresh cadavers). Average duration of follow up was 15.7 months $(14{\sim}21)$. Functional results was analyzed using Brobery and Morrey analysis scale. Results: The approach through the plane between the extensor carpi radialis longus and the extensor carpi radialis brevis was ideal, because it preserves normal anatomy and provides a wide surgical view of the anterior joint. The posterior joint could be approached directly between the medial head of the triceps brachii and brachialis medially, the lateral head of triceps brachii and brachioradialis laterally. In all patients, an improved ROM was obtained with intra and extra-articular adhesiolysis: an average $61.7^{\circ}$ improvement $(50{\sim}75)$. Functional results were as follows: five excellent, one good. In addition, the patients' satisfaction was high since the scar from the operation was only a single line at the posterior surface of the elbow. Conclusion: In the treatment of stiff elbow, posterior extensile approach is thought to be useful because this method provides wide anterior and posterior surgical view.

Keywords

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