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We present our results of radical arthrolysis with twin incisions with the use of a monolateral hinged fixator to treat very severe extra-articular contracture of the elbow. This retrospective study included 26 patients (15 males and 11 females) with a mean age of 30 years (12 to 60). The mean duration of stiffness was 9.1 months (5.4 to 18) with mean follow-up of 5.2 years (3.5 to 9.4). The mean pre-operative arc of movement was 15.6\u00b0 (0\u00b0 to 30\u00b0), with mean pre-operative flexion of 64.1\u00b0 (30\u00b0 to 120\u00b0) and mean pre-operative extension of 52.1\u00b0 (10\u00b0 to 90\u00b0). Post-operatively the mean arc improved to 102.4\u00b0 (60\u00b0 to 135\u00b0), the mean flexion improved to 119.1\u00b0 (90\u00b0 to 140\u00b0) and mean extension improved to 16.8\u00b0 (0\u00b0 to 30\u00b0) (p &lt; 0.001). The Mayo elbow score improved from a mean of 45 (30 to 65) to 89 (75 to 100) points, and 13 had excellent, nine had good, three had fair and one had a poor result. We had one case of severe instability and one wound dehiscence which responded well to treatment. One case had deep infection with poor results which responded well to treatment. <\/jats:p><jats:p> Our findings indicate that this method is very effective in the treatment of severe elbow contracture; however, a randomised controlled study is necessary for further evaluation. <\/jats:p>","DOI":"10.1302\/0301-620x.92b1.22241","type":"journal-article","created":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:22:43Z","timestamp":1262305363000},"page":"92-97","source":"Crossref","is-referenced-by-count":38,"title":["Management of severe extra-articular contracture of the elbow by open arthrolysis and a monolateral hinged external fixator"],"prefix":"10.1302","volume":"92-B","author":[{"given":"G. 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