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Does the injury site of the anterior capsule of elbow joint affect the flexion contracture?
In Hyeok Rhyou,Kyung Chul Kim,Ji-ho Lee,Jung Hyun Lee,Hyeong Jin Kim,kee Baek Ahn 대한견주관절의학회 2021 대한견주관절학회 학술대회논문집 Vol.2021 No.3
Introduction and Background Long-term immobilization after closed reduction of the dislocation of the elbow joint is associated with development of joint stiffness. Especially, fibrosis of the anterior joint capsule is known as a main cause of the flexion contracture. However, we have experienced that the flexion contracture was not observed after more than 4 weeks immobilization for the distal humerus fracture. In this background, we decided to investigate that the site of the anterior capsule tear is associated with flexion contracture. Material and Method Thirty patients with simple posterolateral elbow dislocation and 21 patients with distal humerus coronal shear fractures (11 patients immobilized for less than 4 weeks and 10 patients immobilized for more than 4 weeks after surgical fixation) were enrolled in this study. Preoperative MRIs were taken all patients. The site of anterior capsular tear was divided into proximal, middle and distal with MRI. Statistical analyses were performed to compare range of motion at last follow-up and site of anterior capsular tear of 2 groups. Results Anterior capsule injuries were found all patients with posterolateral dislocation in distal (19 cases) and middle (11 cases) site. All patients with coronal shear fracture were injured proximal site. Statistical analysis regarding tear site showed significant difference between 2 groups (p<0.001). In coronal shear fracture group, the flexion contracture was 2 degrees (0-10 degrees) for patients with less than 4 weeks immobilization and 10 degrees (0-20 degrees) in 10 patients for more than 4 weeks. ROM of both groups were within normal range. However, there was statistical difference between different period of immobilization (p=0.018). Conclusions In this study, development of flexion contracture was related with the site of ??the torn anterior capsule. If the torn site of anterior joint capsule can be identified preoperatively, the risk of flexion contracture after prolonged immobilization can be evaluated