REHABILITATION OF PATIENTS WITH ELBOW JOINT CONTRACTURE IN IMPROPERLY UNIONED SUPRECONDYL FRACTURES OF THE HUMERUS
Keywords:
supracondylar fracture, elbow joint contracture, rehabilitationAbstract
The article presents the dynamics of elbow joint contracture development in cases of improperly healed supracondylar fractures of the humerus, as well as describes approaches to the rehabilitation of such patients. The course of the contracture depends on the time elapsed since the injury, as well as on the initial range of motion in the joint before the start and after the completion of the inpatient stage of conservative treatment. An analysis was carried out of the treatment results in 68 patients with supracondylar fractures of the humerus. It was found that in improperly healed fractures with complete displacement of the distal fragment anteriorly or posteriorly, the degree of proximal displacement plays an important role. In the absence of proximal displacement and with a period of 40–65 days after injury, it is possible to achieve a significant range of motion in the joint (flexion — 50°, extension — 160° or more).
References
Agranovich, O. E., Petrova, E. V., Trofimova, S. I., Batkin, S. F., Kochenova, E. A., Kenis, V. M., Sapogovsky, A. V., Melchenko, E. V., Afonichev, K. A., & Blagoveshchensky, E. D. (2023). Restoration of active elbow flexion in children with amyoplasia: What is the optimal age for surgery? Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 11(1), 29–38. (in Russ).
Baimbetov, G. J., & Khodzhanov, I. Yu. (2021). New approaches to the treatment of children with post-traumatic elbow contractures. Geniy Ortopedii, (5). (in Russ).
Chibirov, G. M., & Soldatov, Yu. P. (2013). Treatment of patients with elbow joint dysfunction associated with post-traumatic pseudoarthrosis of the humeral condyle. Geniy Ortopedii, (3), 80–81. (in Russ).
Kalantyrskaya, V. A., Klyuchevsky, V. V., Perova, V. A., & Piskun, M. S. (2015). Prevention of contractures in the treatment of elbow joint injuries. Polytrauma, (2), 50–58. (in Russ).
Khodorovskaya, A. M., Efimtsev, A. Yu., Agranovich, O. E., Savina, M. V., Zorin, V. I., Brailov, S. A., Arakelyan, A. I., Lukyanov, S. A., Grishchenkov, A. S., Filin, Ya. A., Vcherashny, D. B., & Morozova, V. V. (2024). Diffusion-tensor magnetic resonance imaging in patients with consequences of unilateral obstetric brachial plexus injuries. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 12(2), 185–196. (in Russ).
Merkulov, V. N., Dergachev, D. A., & Dorokhin, A. I. (2014). Arthroplasty in the treatment of post-traumatic contractures and ankylosis of the elbow joint in children. Pediatric Surgery, (4), 34–38. (in Russ).
Novikov, V. A., Umnov, V. V., Zharkov, D. S., Barlova, O. V., Mustafaeva, A. R., & Vissarionov, S. V. (2024). Evaluation of the effectiveness of diagnostic blockade of the motor branches of the median nerve in patients with cerebral palsy from the perspective of modeling the outcome of selective neurectomy. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 12(2), 173–183. (in Russ).
Oganesyan, O. V., & Muradyan, D. R. (2008). Errors and complications in restoring the shape and function of the elbow joint using a hinged distraction device. Bulletin of Traumatology and Orthopaedics named after N. N. Priorov, (3), 33–42. (in Russ).
Oganesyan, O. V., & Muradyan, D. R. (2008). Restoration of the shape and function of the elbow joint (errors and complications). Geniy Ortopedii, (2), 71–76. (in Russ).
Paul S.K., Hotchkiss R.N. Outcomes after operative treatment of elbow contractures in the pediatric and adolescent population // J. Shoulder Elbow Surg. 2016. Vol. 25, No 12. P. 2066-2070. DOI: 10.1016/j.jse.2016.09.008.
Piper S.L., Lattanza L.L., Shen T.S., Wall L.B., Goldfarb C.A. Open Surgical Release of Posttraumatic Elbow Contracture in Children and Adolescents / // J. Pediatr. Orthop. 2019. Vol. 39, No 5. P. 241-246. DOI: 10.1097/BPO.0000000000000923.
Proshchenko, Ya. N., & Pozdeeva, N. A. (2012). Long-term results of treatment of children with elbow joint contractures. Geniy Ortopedii, (2), 94–98. (in Russ).
Sheps D.M., Hildebrand K.A., Boorman R.S. Simple dislocations of the elbow: evaluation and treatment // Hand Clin. 2004. Vol. 20, No 4. P. 389- 404. DOI: 10.1016/j.hcl.2004.07.002.
Soldatov, Yu. P. (2004). Reconstructive-restorative treatment of consequences of elbow joint injuries using the Ilizarov apparatus [Doctoral dissertation abstract]. Kurgan. (in Russ).
Stein D.A., Patel R., Egol K.A., Kaplan F.T., Tejwani N.C., Koval K.J. /Prevention of heterotopic ossification at the elbow following trauma using radiation therapy // Bull. Hosp. Jt. Dis. 2003. Vol. 61, No 3-4. P. 151-154.
Urinbaev, P., & Eranov, N. F. (2000). Treatment of elbow joint contractures in children. In Proceedings of the Scientific-Practical Conference “Actual Problems of Traumatology and Orthopaedics” (pp. 4–5). Karshi. (in Russ).
Zorin, V. I., Lukyanov, S. A., & Grybok, D. Yu. (2024). Consequences of elbow fractures in children. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 12(4), 419–426. (in Russ).