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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Open arthrolysis on tuberculosis oriented elbow stiffness

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  • presenting/speaker Cunyi Fan - Shanghai Sixth People's Hospital, Shanghai, China
  • Yun Qian - Shanghai Sixth People's Hospital, Shanghai, China

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-208

doi: 10.3205/19ifssh1437, urn:nbn:de:0183-19ifssh14371

Published: February 6, 2020

© 2020 Fan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: In the past decades, tuberculosis (TB) has posed a great threat to people worldwide, especially in developing regions. Bone and joint TB is one of the most common types of extrapulmonary TB, with elbow TB comprising a small proportion of these cases. The treatment for elbow stiffness associated with TB has been rarely reported.

Methods: We retrospectively analyzed six patients (four females and two males) with tubercular elbow stiffness during a 7-year period. All of them received open arthrolysis and hinged external fixation to restore functional extension, flexion, supination and pronation. Mayo Elbow Performance Score (MEPS) and range of motion (ROM) were evaluated preoperatively and at final follow-up.

Results and Conclusions: At final follow-up after surgery, we evaluated the average active ROM, which was 111.7° (90°-135°). The average extension was 11.7° (0°-30°), while the average flexion was 123.3° (115°-135°). At the same time, the average supination was increased to 70° (40°-90°) and the average pronation was increased to 68.3° (45°-80°). The MEPS was elevated to 92.5 (85-100). Three patients displayed complications and were treated and cured with dressing changes and antibiotics.

We conclude that open arthrolysis and hinged external fixation are useful for the treatment of nontraumatic elbow stiffness with tuberculosis.