{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:36:44Z","timestamp":1740148604165,"version":"3.37.3"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>\n          Objetivo\u2003Demonstrar os resultados cl\u00ednicos e a taxa de complica\u00e7\u00f5es da libera\u00e7\u00e3o cir\u00fargica por via \u00fanica posterior no tratamento da rigidez p\u00f3s-traum\u00e1tica de cotovelo.<\/jats:p><jats:p>\n          M\u00e9todos\u2003Estudo prospectivo, com pacientes submetidos a cirurgia entre maio de 2013 e junho de 2018 em um \u00fanico centro. Foi realizado acesso ao cotovelo por via posterior. O seguimento dos pacientes foi feito por uma equipe de terapia ocupacional, e eles foram submetidos a um protocolo de reabilita\u00e7\u00e3o padronizado, com \u00f3rteses est\u00e1ticas progressivas e din\u00e2micas. O desfecho prim\u00e1rio foi a amplitude de flexoextens\u00e3o do cotovelo ap\u00f3s 6 meses.<\/jats:p><jats:p>\n          Resultados\u2003Um total de 26 pacientes completaram o seguimento m\u00ednimo de 6 meses. A m\u00e9dia de flexoextens\u00e3o do cotovelo, ao final de 6 meses, foi de 98,3\u00b0\u2009\u00b1\u200922,0\u00b0, com um ganho de amplitude de 40,0\u00b0\u2009\u00b1\u200914,0\u00b0 em rela\u00e7\u00e3o ao pr\u00e9-operat\u00f3rio (p\u2009&lt;\u20090,001). A m\u00e9dia de ganho relativo de flexoextens\u00e3o, ao final de 6 meses, foi de 51,7%\u2009\u00b1\u200917,1% (p\u2009&lt;\u20090,001). A m\u00e9dia de pronossupina\u00e7\u00e3o, ao final de 6 meses, foi de 129,0\u00b0\u2009\u00b1\u200942,7\u00b0 (p\u2009&lt;\u20090,001). Metade dos casos apresentava rigidez moderada e grave no pr\u00e9-operat\u00f3rio, contra 7,7% aos 6 meses de p\u00f3s-operat\u00f3rio (p\u2009&lt;\u20090,001). A pontua\u00e7\u00e3o nos instrumentos Mayo Elbow Performance Score (MEPS) e Disabilities of the Arm, Shoulder and Hand (DASH) apresentou melhora estatisticamente significativa em rela\u00e7\u00e3o ao pr\u00e9-operat\u00f3rio, atingindo 74,4\u2009\u00b1\u200916,8 pontos e 31,7\u2009\u00b1\u200921,9 pontos, respectivamente. A escala visual anal\u00f3gica (EVA) n\u00e3o apresentou diferen\u00e7a estatisticamente significativa em rela\u00e7\u00e3o ao pr\u00e9-operat\u00f3rio (p\u2009=\u20090,096). Complica\u00e7\u00f5es foram observadas em 6 (23%) pacientes, n\u00e3o sendo necess\u00e1ria nova abordagem cir\u00fargica em nenhum paciente.<\/jats:p><jats:p>\n          Conclus\u00f5es\u2003A libera\u00e7\u00e3o cir\u00fargica do cotovelo associada a protocolo de reabilita\u00e7\u00e3o \u00e9 t\u00e9cnica segura, com resultados satisfat\u00f3rios e baixa taxa de complica\u00e7\u00f5es.<\/jats:p>","DOI":"10.1055\/s-0039-1700827","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T23:50:34Z","timestamp":1578613834000},"page":"570-578","source":"Crossref","is-referenced-by-count":1,"title":["Tratamento cir\u00fargico da rigidez p\u00f3s-traum\u00e1tica do cotovelo por via posterior ampla"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0214-9576","authenticated-orcid":false,"given":"Mauro E.C.","family":"Gracitelli","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9sar L.B.","family":"Guglielmetti","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caio A.S.","family":"Botelho","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo A.","family":"Malavolta","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge H.","family":"Assun\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnaldo A.","family":"Ferreira Neto","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Cl\u00ednicas, Faculty of Medicine, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2106\/00004623-198163060-00002","article-title":"A biomechanical study of normal functional elbow motion","volume":"63","author":"B F Morrey","year":"1981","journal-title":"J Bone Joint Surg Am"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"471","DOI":"10.2106\/JBJS.I.01633","article-title":"Functional elbow range of motion for contemporary tasks","volume":"93","author":"M Sardelli","year":"2011","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.jse.2010.11.018","article-title":"Arthroscopic arthrolysis for posttraumatic elbow stiffness","volume":"20","author":"I Cefo","year":"2011","journal-title":"J Shoulder Elbow Surg"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/17453670710014798","article-title":"Surgical treatment of posttraumatic stiffness of the elbow: 2-year outcome in 21 patients after a column procedure","volume":"79","author":"U Gundlach","year":"2008","journal-title":"Acta Orthop"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jse.2012.11.010","article-title":"Surgical treatment of post-traumatic elbow stiffness: a systematic review","volume":"22","author":"I F Kodde","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"e97476","DOI":"10.1371\/journal.pone.0097476","article-title":"Complications of treating terrible triad injury of the elbow: a systematic review","volume":"9","author":"H W Chen","year":"2014","journal-title":"PLoS One"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jse.2010.07.013","article-title":"Elbow joint contracture after traumatic injury","volume":"20","author":"C Myden","year":"2011","journal-title":"J Shoulder Elbow Surg"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.2106\/JBJS.H.01594","article-title":"Health status after open elbow contracture release","volume":"92","author":"A L Lindenhovius","year":"2010","journal-title":"J Bone Joint Surg Am"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.2106\/00004623-198567080-00003","article-title":"Correction of post-traumatic flexion contracture of the elbow by anterior capsulotomy","volume":"67","author":"J R Urbaniak","year":"1985","journal-title":"J Bone Joint Surg Am"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/BF00268509","article-title":"Operation for the stiff elbow","volume":"13","author":"Y Itoh","year":"1989","journal-title":"Int Orthop"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1016\/S1058-2746(95)80080-8","article-title":"Release of the stiff elbow followed by continuous passive motion and indomethacin treatment","volume":"4","author":"J O S\u00f8jbjerg","year":"1995","journal-title":"J Shoulder Elbow Surg"},{"issue":"08","key":"ref13","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.jse.2013.04.003","article-title":"Effectiveness of bracing in the treatment of nonosseous restriction of elbow mobility: a systematic review and meta-analysis of 13 studies","volume":"22","author":"A M M\u00fcller","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1302\/0301-620X.94B3.27278","article-title":"Outcomes of open arthrolysis of the elbow without post-operative passive stretching","volume":"94","author":"Z CJ Higgs","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"293","key":"ref15","first-page":"46","article-title":"Distraction arthroplasty. Clinical applications","author":"B F Morrey","year":"1993","journal-title":"Clin Orthop Relat Res"},{"issue":"03","key":"ref16","first-page":"325","article-title":"Arthroscopic treatment of post-traumatic elbow stiffness","volume":"47","author":"J C J\u00fanior","year":"2015","journal-title":"Rev Bras Ortop"},{"issue":"16","key":"ref17","doi-asserted-by":"crossref","first-page":"2692","DOI":"10.2106\/JBJS.I.01367","article-title":"Surgical release for posttraumatic loss of elbow flexion","volume":"92","author":"M J Park","year":"2010","journal-title":"J Bone Joint Surg Am"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"479","DOI":"10.2106\/00004623-199274040-00003","article-title":"Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow","volume":"74","author":"B F Morrey","year":"1992","journal-title":"J Bone Joint Surg Am"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1590\/S0100-879X2005000200018","article-title":"Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand Questionnaire","volume":"38","author":"A G Orfale","year":"2005","journal-title":"Braz J Med Biol Res"},{"issue":"04","key":"ref20","first-page":"385","article-title":"[Elbow arthrolysis in post-traumatic rigidities]","volume":"41","author":"J Cauchoix","year":"1975","journal-title":"Acta Orthop Belg"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jse.2007.03.014","article-title":"Primary osteoarthritis of the elbow: lack of radiographic evidence for morphologic predisposition, results of operative debridement at intermediate follow-up, and basis for a new radiographic classification system","volume":"17","author":"L A Rettig","year":"2008","journal-title":"J Shoulder Elbow Surg"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jse.2012.10.024","article-title":"Surgical release of elbow stiffness after internal fixation of intercondylar fracture of the distal humerus","volume":"22","author":"K H Koh","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1590\/S0102-36162010000600004","article-title":"Avalia\u00e7\u00e3o dos resultados do tratamento cir\u00fargico da rigidez p\u00f3s-traum\u00e1tica do cotovelo de pacientes esqueleticamente maturos","volume":"45","author":"A N Miyazaki","year":"2010","journal-title":"Rev Bras Ortop"},{"issue":"04","key":"ref24","first-page":"453","article-title":"Results of open arthrolysis for elbow stiffness. A series of 22 cases","volume":"77","author":"D Ayadi","year":"2011","journal-title":"Acta Orthop Belg"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/BF00180451","article-title":"Arthrolysis for post-traumatic stiffness of the elbow","volume":"17","author":"A L Boerboom","year":"1993","journal-title":"Int Orthop"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1097\/01.ta.0000196000.96056.51","article-title":"Outcome of open release for post-traumatic elbow stiffness","volume":"61","author":"V Tan","year":"2006","journal-title":"J Trauma"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"e0138547","DOI":"10.1371\/journal.pone.0138547","article-title":"Complications of Open Elbow Arthrolysis in Post-Traumatic Elbow Stiffness: A Systematic Review","volume":"10","author":"J Cai","year":"2015","journal-title":"PLoS One"},{"issue":"09","key":"ref28","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.2106\/00004623-200409000-00014","article-title":"Anterior release of the elbow for extension loss","volume":"86","author":"J M Aldridge III","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"382","DOI":"10.2106\/00004623-200203000-00008","article-title":"Operative treatment of elbow contracture in patients twenty-one years of age or younger","volume":"84","author":"A A Stans","year":"2002","journal-title":"J Bone Joint Surg Am"}],"container-title":["Revista Brasileira de Ortopedia"],"original-title":[],"language":"pt","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1700827.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T22:57:06Z","timestamp":1603234626000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1700827"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,9]]},"references-count":28,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,10,20]]},"published-print":{"date-parts":[[2020,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1700827","relation":{},"ISSN":["0102-3616","1982-4378"],"issn-type":[{"type":"print","value":"0102-3616"},{"type":"electronic","value":"1982-4378"}],"subject":[],"published":{"date-parts":[[2020,1,9]]}}}