The relation between elbow range of motion and patient satisfaction after open release of stiff elbow

Abstract

Objective: The aim of this retrospective study was toŞnd out whether a cut off value existed for elbowflexion and extension after open surgical release of elbow contracture that would correlate with subjective patient satisfaction.Methods: The study enrolled 77 patients (53 males and 24 females with a mean age of 35.1 (18e77) yearsat the time of operation) with elbow contracture who attended regular follow-up appointments for morethan 12 months. The mean follow up period was 44.2 months (12e186). The preoperative and postoperative modiŞed MAYO elbow scores, objective parameters of increase in both flexion and extensionend point measurements and improvement in total ROM were compared in order to determine the cutoff degree of ROM in bothflexion and extension that signiŞcantly correlated with patient satisfaction.Results: Of the 77 participating patients, 26 patients had an extrinsic (33.8%) and 51 patients had anintrinsic elbow contracture (66.2%). Surgeries performed involved 40 cases of lateral release and 37 casesof both lateral and medial (progressive) release. The median preoperative totalflexion-extension arch(ROM) was 45(20e65). The median postoperative totalflexion-extension arch (ROM) was 110(97.5e125). The modiŞed MAYO elbow score improved from 60 to 85 points postoperatively. The postoperativeflexion cut off value was 115for an excellent or good postoperative modiŞed MAYO elbowscore.Conclusion: Post-operativeflexion cut off value was 115and had a positive effect on the postoperativepatient satisfaction. The cut off value for postoperative extension was 20but it was not a signiŞcantvariable on patient satisfaction as was the total increase in ROM.Level of signiŞcance: Level IV Therapeutic Study.