Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up

Abstract Objective Patients with severe burns may develop heterotopic ossification (HO), articular cartilage loss, and soft tissue contracture in the elbow, significantly limiting elbow function and diminishing quality of life. Open elbow arthrolysis (OEA) combined with hinged external fixation (HEF...

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Main Authors: Yuanhao Tong, Yaowei Lv, Xinyu Wang, Cunyi Fan, Yuanming Ouyang
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-06155-7
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author Yuanhao Tong
Yaowei Lv
Xinyu Wang
Cunyi Fan
Yuanming Ouyang
author_facet Yuanhao Tong
Yaowei Lv
Xinyu Wang
Cunyi Fan
Yuanming Ouyang
author_sort Yuanhao Tong
collection DOAJ
description Abstract Objective Patients with severe burns may develop heterotopic ossification (HO), articular cartilage loss, and soft tissue contracture in the elbow, significantly limiting elbow function and diminishing quality of life. Open elbow arthrolysis (OEA) combined with hinged external fixation (HEF) has demonstrated efficacy in managing severe elbow stiffness. However, no recent studies have specifically investigated its application in postburn elbow stiffness. This study evaluates the clinical outcomes of OEA with HEF in patients with postburn elbow stiffness, with an average follow-up period of four years. Methods This study included patients with postburn elbow stiffness treated between May 2018 and December 2021. Eleven participants underwent OEA combined with HEF and were followed up for an average of 50.7 months (range: 37–62 months). Pre- and postoperative data, including elbow and forearm mobility, functional improvements, radiographic results, and complications, were systematically collected and analysed. Results Substantial improvements were observed in elbow and forearm mobility, with preoperative flexion-extension arc increasing from 14° to 77° and forearm rotation improving from 83° to 105° at the final follow-up (P < 0.001). Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) score and the Mayo Elbow Performance Index (MEPI) significantly improved (P < 0.001). Pain levels notably decreased (P < 0.001). Postoperative complications include transient ulnar nerve symptoms in 2 patients, pain in 3 patients, and 1 HO recurrence. Conclusion Burn-related elbow stiffness patients treated with OEA and HEF showed encouraging clinical results, marked by notable enhancements in elbow movement and functionality. The results proved the technique effective for elbow stiffness after burn injury. Level of evidence Level IV, Case Series, Treatment Study.
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spelling doaj-art-8d72c3fb10e14ba0ae2fa8a521d8e2f52025-08-20T03:46:28ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-08-012011810.1186/s13018-025-06155-7Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-upYuanhao Tong0Yaowei Lv1Xinyu Wang2Cunyi Fan3Yuanming Ouyang4Department of Orthopedics, National Center for Orthopedics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, National Center for Orthopedics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, National Center for Orthopedics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, National Center for Orthopedics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, National Center for Orthopedics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineAbstract Objective Patients with severe burns may develop heterotopic ossification (HO), articular cartilage loss, and soft tissue contracture in the elbow, significantly limiting elbow function and diminishing quality of life. Open elbow arthrolysis (OEA) combined with hinged external fixation (HEF) has demonstrated efficacy in managing severe elbow stiffness. However, no recent studies have specifically investigated its application in postburn elbow stiffness. This study evaluates the clinical outcomes of OEA with HEF in patients with postburn elbow stiffness, with an average follow-up period of four years. Methods This study included patients with postburn elbow stiffness treated between May 2018 and December 2021. Eleven participants underwent OEA combined with HEF and were followed up for an average of 50.7 months (range: 37–62 months). Pre- and postoperative data, including elbow and forearm mobility, functional improvements, radiographic results, and complications, were systematically collected and analysed. Results Substantial improvements were observed in elbow and forearm mobility, with preoperative flexion-extension arc increasing from 14° to 77° and forearm rotation improving from 83° to 105° at the final follow-up (P < 0.001). Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) score and the Mayo Elbow Performance Index (MEPI) significantly improved (P < 0.001). Pain levels notably decreased (P < 0.001). Postoperative complications include transient ulnar nerve symptoms in 2 patients, pain in 3 patients, and 1 HO recurrence. Conclusion Burn-related elbow stiffness patients treated with OEA and HEF showed encouraging clinical results, marked by notable enhancements in elbow movement and functionality. The results proved the technique effective for elbow stiffness after burn injury. Level of evidence Level IV, Case Series, Treatment Study.https://doi.org/10.1186/s13018-025-06155-7Elbow stiffnessBurn injuryHeterotopic ossificationOpen elbow arthrolysisRange of motion
spellingShingle Yuanhao Tong
Yaowei Lv
Xinyu Wang
Cunyi Fan
Yuanming Ouyang
Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up
Journal of Orthopaedic Surgery and Research
Elbow stiffness
Burn injury
Heterotopic ossification
Open elbow arthrolysis
Range of motion
title Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up
title_full Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up
title_fullStr Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up
title_full_unstemmed Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up
title_short Open elbow arthrolysis with hinged external fixation for postburn elbow stiffness: a case series with an averaged 4-year follow-up
title_sort open elbow arthrolysis with hinged external fixation for postburn elbow stiffness a case series with an averaged 4 year follow up
topic Elbow stiffness
Burn injury
Heterotopic ossification
Open elbow arthrolysis
Range of motion
url https://doi.org/10.1186/s13018-025-06155-7
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