Thirty-three patients who had a post-traumatic flexion contracture of
the elbow were managed consecutively with anterior capsulotomy without
tenotomy of the biceps tendon or myotomy of the brachialis muscle. The
first fifteen patients (Group I) did not receive continuous passive motion
postoperatively. Preoperative active extension for Group I was to an
average of 48 degrees short of full extension, which improved to 19 degrees
at a mean follow-up time of forty-five months. Subsequently, eighteen
patients (Group II) received continuous passive motion postoperatively for
a mean of six weeks. Preoperative active extension for Group II was to an
average of 55 degrees short of full extension, which improved to 23 degrees
at a mean duration of follow-up of thirty-five months. The mean
preoperative arc of motion for Group I was 69 degrees, which improved to 94
degrees postoperatively. The mean preoperative arc of motion for Group II
was 48 degrees, which improved to 95 degrees postoperatively. Five patients
in Group I and six patients in Group II had severe preoperative heterotopic
ossification. There was no correlation, however, between preoperative
heterotopic ossification and the amount that extension of the elbow
improved postoperatively. There was no postoperative increase in
heterotopic ossification. Four patients in Group I and six patients in
Group II had severe post-traumatic osteoarthrosis preoperatively. Anterior
capsulotomy is an effective treatment of post-traumatic flexion contracture
of the elbow. Although the postoperative use of continuous passive motion
did not significantly improve mean active extension, it did improve active
flexion and the total arc of motion.