The Recovery Model Of The Strength Of The Upper Extremities After Elbow Arthrolysis

PurposeElbow stiffness is one of the most common complications after elbow injury.At present,elbow release is the main method to restore elbow mobility.Surgical removal of the surrounding heterotopic ossification,joint capsule,contracture of the ligaments and other soft tissue,will also move the tendon insertion site.Early postoperative patients often have significant loss of muscle strength,with continuous rehabilitation training,strength gradually increased but the final result of the recovery varies.This topic will explore the short-term and long-term effects of elbow arthrolysis on the strength of flexion and extension of elbows,of wrists and grip strength.Through the analysis and study of risk factors to verify the safety of this surgical approach and to explore the gender and dominance on postoperative muscle strength recovery.The establishment of muscle strength recovery model of postoperative patients is good for the development of clinical treatment of elbow stiffness and postoperative rehabilitation training based on theories and clinical evidences.MethodThis topic is a prospective,self-controlled cohort clinical study.For patients with post-traumatic elbow stiffness in our hospital from June 2014 to December 2014,a total of 32 patients were included in the study according to the inclusion and exclusion criteria.The use of open elbow arthrolysis and standardized postoperative rehabilitation program.The elbow flexion and extension strength,grip strength,elbow range of motion and Mayo elbow function score were recorded preoperatively,at postoperative 2 weeks,6 weeks,6 months,1 year and the last follow-up day(mean follow-up was 26.13 months).We also analyzed other indicators,the effectiveness and safety of surgery and at the same time,we used statistical methods to analyze the impact of gender and the dominance on muscle strength recovery,so as to establish the muscle strength recovery model.ResultsThe average follow-up was 26.13 months.The elbow mobility improved from 46 ° before surgery to 127 ° at the last follow-up day.The Mayo score of the elbow improved significantly from 67.97 to 96.86 before surgery(P <0.05).Short-term postoperatively,all patients had significant decreases in isometric muscle strength and grip strength(P <0.001);however,at the last follow-up day,there was no significant decrease in isometric strength for all muscle groups(P> 0.05).After 7 days,there was no significant difference in muscle strength recovery between male and female(P> 0.05).After 7 days,the strength of male muscle growth was significantly higher than that of female,but the ratio of isometric muscle strength did not differ between the two sexes.At all-time points of follow-up,there was no significant difference in muscle strength and grip between the dominant and the non-dominant side(P> 0.05).ConclusionOpen elbow release can significantly improve elbow mobility and elbow function scores.Surgery does not have long-term effects on isometric muscle strength of elbow flexion and extension,wrist flexion and extension and grip strength.During the entire follow-up period,the increase of muscle strength was significantly higher in males than in females.The recovery of muscle strength was in proportion to the individual’s basic level of muscle strength,and the pattern of muscle strength recovery was the same in both sexes.The dominance has no effect on the recovery of isometric muscle strength throughout the upper extremities.