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Saturday, March 18, 2000

Elbow contractures released via incisions permitting resection

In a study presented by co-author Joseph DiGiovanni, MD, a fellow at the Hospital for Joint Diseases, New York City, 27 elbow contractures were released through medial, lateral or combined incisions pemitting resection of heterotopic ossification (HO), scar and release of capsular and/or muscular contractures. The critical anterior band of the ulnar collateral ligament was preserved or reconstructed, and a hinged extemal fixator was used if there was instability or residual muscle contracture. Indwelling axillary catheters were used to allow immediate unrestricted active range of motion. His findings were presented in scientific poster 336.

"Emphasis must be placed on performing a comprehensive release, preserving the medial collateral ligament and on starting early active range of motion post-operatively," said Dr. DiGiovanni.

The average preoperative flexion/extension arc of motion was 63 degrees (range: 25-115 degrees); average post-operative flexion/extension arc of motion was 127 degrees (range: 0-140 degrees); and the average increase in the flexion/extension arc was 64 degrees. No recurrences in severe flexion contracture or in formation of HO were seen. All patients were satisfied with their range of motion and patients who participated in sports were able to return to them.

Co-authors of the study with Dr. DiGiovanni are Michael Hauseman, MD, attending microvascular surgeon, and Lee M. Kupersmith, MD, resident, both from Mount Sinai Hospital, New York City.

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2000 Academy News March 18 Index C

Last modified 24/February/2000 by IS