Der Unfallchirurg
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[Performance control after arthroscopic arthrolysis with capsulectomy in fresh-frozen elbow joints].
Posttraumatic or postoperative movement restrictions in elbow joints can often occur (including capsular contracture) and can generate everyday limitations. In persistent elbow stiffness, arthroscopic arthrolysis with removal of the dorsal and ventral capsule portions can be carried out. The purpose of this study was to assess the efficacy of arthroscopic capsulectomy by means of an in vitro anatomical study. ⋯ Arthroscopic arthrolysis can be performed with a high degree of radicality. The radicality must be self-critically taken into account in one's own action. The radicality of the portal change may even be higher ventrally than with an isolated column procedure. On the other hand, it must be critically considered that posteriorly, the PML cannot be adequately addressed by means of arthroscopy due to the risk of ulnar nerve injury. Portal changes might help to enable a more complete visualization of the joint capsule and may avoid leaving possibly relevant remnants of the capsule. If a release of the PML is required, this may have to be carried out in combination with an ulnar nerve release in a mini-open technique.
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Tibial bony avulsion fractures of the posterior cruciate ligament (PCL) are rare injuries and in certain cases a delayed healing or non-union can occur under conservative treatment. ⋯ The indications for MRI diagnostics should be generously considered, Smoking appears to be associated with an increased risk of pseudarthrosis. Good results can be achieved with a minimally invasive posterior screw approach, even after a delay.