Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 15;29(4):e178-e187.
doi: 10.5435/JAAOS-D-18-00801.

Risk Factors for Elbow Joint Contracture After Surgical Repair of Traumatic Elbow Fracture

Kurtis D Carlock  1 , Isabella R Bianco, David N Kugelman, Sanjit R Konda, Kenneth A Egol
Affiliations

Risk Factors for Elbow Joint Contracture After Surgical Repair of Traumatic Elbow Fracture

Kurtis D Carlock et al. J Am Acad Orthop Surg. .

Abstract

Purpose: The ability to predict contracture development after elbow fracture would benefit patients and physicians. This study aimed to identify factors associated with the development of posttraumatic elbow joint contracture.

Methods: A retrospective review of elbow fractures (AO/Orthopaedic Trauma Association [OTA] type 13 and 21) treated at one institution between 2011 and 2015 was performed. Data collected included demographics, injury information, treatment, and postoperative elbow range of motion (ROM). Multivariate logistic regression analyses were performed to identify factors associated with contracture development. Notable contracture was defined as an arc of motion less than 100° flexion/extension, which has been associated with reduced ability to perform activities of daily living.

Results: A total of 278 patients at least 1 8 years of age underwent surgical repair of an elbow fracture or fracture-dislocation during the study period and had at least 6 months of postoperative follow-up. Forty-two (15.1%) developed a clinically notable elbow contracture, of whom 29 (69.0%) developed heterotopic ossification (HO). Multivariate analysis of preoperative variables demonstrated that AO/OTA 13-C fracture classification (odds ratio [OR], 13.7, P = 0.025), multiple noncontiguous fractures (OR, 3.7, P = 0.010), and ulnohumeral dislocation at the time of injury (OR, 4.9, P = 0.005) were independently associated with contracture development. At 6 weeks postoperatively, an arc of elbow ROM less than 50° flexion/extension (OR, 23.0, P < 0.0005) and the presence of HO on radiographs (OR, 6.7, P < 0.0005) were found to be independent risk factors for significant elbow stiffness.

Discussion: Ulnohumeral dislocation, multiple noncontiguous fractures, AO/OTA 13-C fracture classification, limited elbow ROM at 6 weeks postoperatively, and the presence of radiographic HO at 6 weeks postoperatively are associated with contracture development after surgical elbow fracture repair. Patients with these risk factors should receive aggressive physical therapy and be counseled as to the possible development of a contracture requiring surgical intervention.

PubMed Disclaimer

References

    1. Nauth A, McKee MD, Ristevski B, Hall J, Schemitsch EH: Distal humeral fractures in adults. J Bone Joint Surg Am 2011;93:686-700.
    1. Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM: The epidemiology of radial head and neck fractures. J Hand Surg Am 2012;37:112-119.
    1. Duckworth AD, Clement ND, Aitken SA, Court-Brown CM, McQueen MM: The epidemiology of fractures of the proximal ulna. Injury 2012;43:343-346.
    1. Schrumpf MA, Lyman S, Do H, et al.: Incidence of postoperative elbow contracture release in New York State. J Hand Surg Am 2013;38:1746-1752.e1-3.
    1. Myden C, Hildebrand K: Elbow joint contracture after traumatic injury. J Shoulder Elbow Surg 2011;20:39-44.

LinkOut - more resources