Open Elbow Contracture Release: Postoperative Management With and Without Continuous Passive Motion

PurposeSurgical contracture release can restore motion to stiff elbows. Some authors suggest that use of continuous passive motion (CPM) in postoperative management can increase ultimate mobility. This study tests the null hypothesis that there is no difference in the arc of flexion and extension between patients who used CPM and those who did not use CPM after open elbow contracture release.MethodsSixteen patients who had an arc of flexion and extension of less than 80° and used CPM after open contracture release were matched based on age, gender, diagnosis, preoperative arc of flexion and extension, and radiographic appearance (joint congruity, heterotopic bone, and arthritis) to 16 control patients who did not use CPM. Stiffness was of posttraumatic origin in 24 patients, related to primary osteoarthrosis in 4 patients, and related to heterotopic ossification after central nervous system injury or burns in 4 patients. The preoperative arc of flexion and extension averaged 38° in the CPM cohort and 42° in the no-CPM cohort.ResultsSubsequent surgeries included procedures to address residual stiffness in 1 patient in the CPM cohort and in 3 patients in the no-CPM cohort. At an average 6 months of follow-up, there was no difference in improvement in the arc of flexion and extension (58° vs 61°) between the CPM and no-CPM cohorts. At the final evaluation, the improvement in arc of flexion and extension (59° in both cohorts) and the final arc of flexion and extension (96° vs 101°) were comparable between cohorts.ConclusionsThese matched retrospective data do not demonstrate a benefit of CPM in the postoperative management of elbow contracture release.Type of study/level of evidenceTherapeutic III.