COA/CSES Elbow Symposium: Post-Traumatic Elbow Stiffness: Questions & Answers

Description

In a discussion led by Chris Hamilton, a panel of specialists addressed various questions on elbow surgery techniques, particularly focusing on ulnar nerve release and post-traumatic capsular releases. Hamilton initiated the Q&A by inviting queries and delved into the specifics of ulnar nerve management with Dr. William Regan. Dr. Regan discussed his protocol for ulnar nerve release related to olecranon fractures, emphasizing that he performs the release almost universally, particularly in cases of severe contracture affecting elbow flexion. Kenneth Faber echoed similar sentiments about approaching the medial side in surgeries, noting the importance of addressing nerve concerns.

The conversation shifted to the topic of heterotopic ossification (HO) prophylaxis, with Dr. Faber sharing insights based on a clinical trial yet to be published, indicating that he typically employs indomethacin for certain fracture types to prevent HO. The participants also discussed the intricacies of arthroscopic procedures, where J Whitcomb Pollock shared his methods and the use of retractors in surgical settings.

The dialogue further explored the application of continuous passive motion (CPM) therapy, revealing a general skepticism among panelists regarding its efficacy and implementation. Finally, the panel addressed advanced surgical scenarios involving the radial head and tendon lengthening, collectively affirming that tendon lengthening is rarely necessary following capsular releases. The session concluded with Hamilton expressing gratitude for the engaging discussions, remarking on the panel's depth of insight.

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