gms | German Medical Science

Objectives/Interrogation: Little is known about the epidemiology of elbow contracture or of elbow contracture release. The purpose of this study was to define the incidence of elbow contracture development and release after surgical treatment for elbow trauma and to identify patient and treatment factors that may predict contracture development.

Methods: We queried a national insurance database from 2007 to 2017 to identify all patients treated for elbow trauma with a minimum of 1-year follow-up. We identified the subset of these patients who had a concomitant diagnosis of contracture on follow-up visit. Procedural codes were used to determine the cohort who underwent contracture release. Mean time to contracture diagnosis and surgical release were calculated. Multivariate regression analysis was performed to calculate the impact of age, Charlson-Dey Comorbidity Index (CCI), head injury, obesity, and anticoagulation use on the progression to elbow contracture release.

Results and Conclusions: The study population included 15,368 patients who were surgically treated for elbow trauma with a minimum of 1 year follow-up after fracture surgery. In total, 1,033 (6.7%) patients were diagnosed with a contracture following fracture and, of those, 79 (0.5%) patients ended up receiving contracture release. On average, time to contracture diagnosis was 3.6 months (SD: 7 months; range: 1 day- 39 months) and time to contracture release was 8.4 months (SD: 10.54 months; range: 1 month-51 months). A CCI of 5, age less than 30, age between 50-69, head injury, obesity and male gender were independently associated with progression to surgical contracture release, whereas use of anticoagulation, CCI less than 5 and age greater than 70 were protective (Table 1 [Tab. 1], Table 2 [Tab. 2]).