Abstract
Arthroscopic management of elbow contractures is rapidly becoming the primary operative
form of treatment for many physicians. Safety concerns remain the primary limiting
factor in its more widespread use. We use an extra-articular starting point in extremely
difficult fixed contractures, and this technique is documented in this report. The
ulnar nerve is initially identified and protected with a palpating finger, while a
periosteal elevator is introduced through a proximal medial skin portal. A channel
between the anterior humeral cortex and anterior musculature is created, and an arthroscope
is introduced through a proximal lateral portal at the lateral aspect of the channel.
The anterior capsule is dissected from the musculature/neurovasculature under direct
vision and safely excised once the medial and lateral margins are safely identified.
A useful technical tip is that retractors can be placed in auxiliary portals to deflect
the muscles and fat pad to improve the ability to perform dissection under direct
vision.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The column procedure: A limited lateral approach for extrinsic contracture of the elbow.J Bone Joint Surg Am. 1998; 80: 1603-1615
- Arthroscopic release of a posttraumatic flexion contracture in the elbow: A case report and review of the literature.Arthroscopy. 1992; 8: 544-547
- Intraarticular capacity and compliance of stiff and normal elbows.Arthroscopy. 1993; 9: 9-13
- Compression neuropathy of the radial nerve as a complication of elbow arthroscopy: A case report and review of the literature.Arthroscopy. 1988; 4: 284-286
- Anterior interosseous nerve injury following elbow arthroscopy.Arthroscopy. 1997; 13: 756-758
- Elbow arthroscopy: A new technique.Arthroscopy. 1989; 5: 222-224
- Neurovascular anatomy and elbow arthroscopy: Inherent risks.Arthroscopy. 1986; 2: 190-197
- Neurovascular anatomy and elbow arthroscopy: Inherent risks, editor’s comment.Arthroscopy. 1986; 2: 190
- Avoiding nerve damage during elbow arthroscopy.J Bone Joint Surg Br. 1993; 75: 129-131
- Risks of neurovascular injury in elbow arthroscopy: Starting anteromedially or anterolaterally?.Arthroscopy. 1991; 7: 287-290
- Radial nerve damage as a complication of elbow arthroscopy.Clin Orthop. 1987; 215: 130-131
- Arthroscopic capsular release of flexion contractures (arthrofibrosis) of the elbow.Arthroscopy. 1993; 9: 277-283
- Complete transection of the median and radial nerves during arthroscopic release of post-traumatic elbow contracture.Arthroscopy. 1999; 15: 784-787
- Neuroanatomy in elbow arthroscopy.J Shoulder Elbow Surg. 1995; 4: 168-174
- Anterior capsulotomy and continuous passive motion in the treatment of post-traumatic flexion contracture of the elbow.J Bone Joint Surg Am. 1992; 74: 1229-1234
- Correction of post-traumatic flexion contracture of the elbow by anterior capsulotomy.J Bone Joint Surg Am. 1985; 67: 1160-1164
Article info
Identification
Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
