New approaches to pediatric treatment of post-traumatic elbow contractures
Abstract. Introduction Post-traumatic elbow contracture is a severe disabling condition of childhood that interferes with both physical and psychic aspects for the child. A high rate of poor results encourages surgeons seek for better surgical treatments. Current diagnostic modalities were practica...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2021-10-01
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| Series: | Гений oртопедии |
| Subjects: |
| _version_ | 1818838604895485952 |
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| author | Gairat D. Bayimbetov Iskandar Yu. Khodzhanov |
| author_facet | Gairat D. Bayimbetov Iskandar Yu. Khodzhanov |
| author_sort | Gairat D. Bayimbetov |
| collection | DOAJ |
| description | Abstract. Introduction Post-traumatic elbow contracture is a severe disabling condition of childhood that interferes with both physical and psychic
aspects for the child. A high rate of poor results encourages surgeons seek for better surgical treatments. Current diagnostic modalities were practical to
get the clinical picture of the contracture mechanogenesis and determine the treatment strategy. The goal of the study was to review long-term results
of new surgical techniques developed for post-traumatic elbow contractures in children. Material and methods The inpatient records of 102 pediatric
patients with post-traumatic elbow contractures operated on with the technique offered were reviewed. All patients underwent conventional radiological,
ultrasound and MSCT examinations. Results Based on the pathobiomechanics of the injured elbow a mobilization technique was developed to ensure
complete bone realignment, relieve pain and allow early exercises for the joint. Postoperative lavage of the joint cavity, intra-articular administration
of corticosteroids and polyvalent enzymes in the early postoperative period facilitated improved long-term outcomes of elbow contractures. All
patients reported good results. Discussion Tenotomies of the lateral ligaments can be added to arthrotomy and reconstruction of articular surfaces
for temporary instability of the joint to restore movement in the elbow joint in severe cases. Post-traumatic elbow contractures are accompanied by
impaired biomechanics. MSCT and 3D reconstruction of bone structures is the gold standard in the diagnosis of post-traumatic elbow contractures.
Conclusion Bone impingements are to be addressed and an extended mobilization of the capsular ligamentous complex be provided for complete
movement recovery through partial elbow instability to be temporarily ensured. Prolonged lavage of the elbow joint can be used to prevent adhesions
and allow early elbow exercises and provide improved outcomes. |
| first_indexed | 2024-12-19T03:41:03Z |
| format | Article |
| id | doaj.art-b04f1294a6e6485dab2c65166b32b26d |
| institution | Directory Open Access Journal |
| issn | 1028-4427 2542-131X |
| language | English |
| last_indexed | 2024-12-19T03:41:03Z |
| publishDate | 2021-10-01 |
| publisher | Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics |
| record_format | Article |
| series | Гений oртопедии |
| spelling | doaj.art-b04f1294a6e6485dab2c65166b32b26d2022-12-21T20:37:15ZengRussian Ilizarov Scientific Center for Restorative Traumatology and OrthopaedicsГений oртопедии1028-44272542-131X2021-10-0127557858310.18019/1028-4427-2021-27-5-578-583New approaches to pediatric treatment of post-traumatic elbow contracturesGairat D. Bayimbetov0Iskandar Yu. Khodzhanov1Republican Specialized Scientific-Practical Centre of Traumatology and Orthopedics, Tashkent, the Republic of UzbekistanRepublican Specialized Scientific-Practical Centre of Traumatology and Orthopedics, Tashkent, the Republic of UzbekistanAbstract. Introduction Post-traumatic elbow contracture is a severe disabling condition of childhood that interferes with both physical and psychic aspects for the child. A high rate of poor results encourages surgeons seek for better surgical treatments. Current diagnostic modalities were practical to get the clinical picture of the contracture mechanogenesis and determine the treatment strategy. The goal of the study was to review long-term results of new surgical techniques developed for post-traumatic elbow contractures in children. Material and methods The inpatient records of 102 pediatric patients with post-traumatic elbow contractures operated on with the technique offered were reviewed. All patients underwent conventional radiological, ultrasound and MSCT examinations. Results Based on the pathobiomechanics of the injured elbow a mobilization technique was developed to ensure complete bone realignment, relieve pain and allow early exercises for the joint. Postoperative lavage of the joint cavity, intra-articular administration of corticosteroids and polyvalent enzymes in the early postoperative period facilitated improved long-term outcomes of elbow contractures. All patients reported good results. Discussion Tenotomies of the lateral ligaments can be added to arthrotomy and reconstruction of articular surfaces for temporary instability of the joint to restore movement in the elbow joint in severe cases. Post-traumatic elbow contractures are accompanied by impaired biomechanics. MSCT and 3D reconstruction of bone structures is the gold standard in the diagnosis of post-traumatic elbow contractures. Conclusion Bone impingements are to be addressed and an extended mobilization of the capsular ligamentous complex be provided for complete movement recovery through partial elbow instability to be temporarily ensured. Prolonged lavage of the elbow joint can be used to prevent adhesions and allow early elbow exercises and provide improved outcomes.elbow jointcontracturesurgical treatmentchildhood |
| spellingShingle | Gairat D. Bayimbetov Iskandar Yu. Khodzhanov New approaches to pediatric treatment of post-traumatic elbow contractures Гений oртопедии elbow joint contracture surgical treatment childhood |
| title | New approaches to pediatric treatment of post-traumatic elbow contractures |
| title_full | New approaches to pediatric treatment of post-traumatic elbow contractures |
| title_fullStr | New approaches to pediatric treatment of post-traumatic elbow contractures |
| title_full_unstemmed | New approaches to pediatric treatment of post-traumatic elbow contractures |
| title_short | New approaches to pediatric treatment of post-traumatic elbow contractures |
| title_sort | new approaches to pediatric treatment of post traumatic elbow contractures |
| topic | elbow joint contracture surgical treatment childhood |
| work_keys_str_mv | AT gairatdbayimbetov newapproachestopediatrictreatmentofposttraumaticelbowcontractures AT iskandaryukhodzhanov newapproachestopediatrictreatmentofposttraumaticelbowcontractures |