The Effects of Age on the Outcomes of Elbow Release in Arthrogryposis.
Academic Article
Overview
abstract
PURPOSE: The goal of this study was to observe the effects of posterior elbow release on children with arthrogryposis at various age points: before the age of 2, between the ages of 2 and 3, and after the age of 3. METHODS: This study was a retrospective chart review of patients with arthrogryposis who underwent a posterior elbow release for an elbow extension contracture between 2007 and 2014 at one institution. Eighteen procedures in 13 patients, who had a minimum follow-up of at least 2 years, were included in the study. Patients were divided into 3 groups based on their age at the time of surgery: <2 years old, 2-3 years old, and >3 years old. Comparisons of the pre- and postoperative passive arcs of motion were made. RESULTS: The average preoperative arc of motion was 16° (0° to 30°) for the children younger than 2, 33.5° (5° to 60°) for the children 2-3, and 45° (25° to 80°) for the children older than 3. The average postoperative arc of motion was 88.2° (70° to 103°), 60° (15° to 85°), and 54.33° (23° to 70°) for the respective age groups. There was a clinically important difference in the postoperative arc of motion between the children less than 2 years old and both the children 2-3 years old and older than 3 years. CONCLUSIONS: This study demonstrates that children who underwent posterior elbow release before the age of 2 had a clinically important increase in their postoperative flexion and overall passive arc of elbow motion compared with older children at medium-term follow-up. The data suggest that earlier release may be better at restoring total passive arc of elbow motion. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
