Arthroscopic Medial Gutter and Posterior Compartment Debridement for Stiff Elbow Utilizing an Outside-In Approach by Posteromedial Dual Portals.

Abstract

Surgical arthrolysis is recommended for patients who suffer from stiff elbow and desire to restore near-normal range of motion and better joint function. Arthroscopic arthrolysis has shown significant advantages over open surgery; however, the close proximity of nerves and blood vessels, along with the limited operating space, presents challenges in performing arthroscopic procedures, and paralysis and injury of the ulnar nerve are frequently encountered. We adopt an arthroscopic posterior medial dual portals technique to expose and protect the ulnar nerve, followed by medial gutter and posterior compartment debridement utilizing an outside-in approach for the stiff elbow. Arthroscopically exposing the ulnar nerve and debriding under viewing via the posterior medial dual portals has the advantages of easier identification of lesions and more comprehensive debridement, reduced postoperative scarring and pain, faster postoperative return to life and work, and reduced risk of neurovascular injury.