![]() Subjects were identified using Current Procedural Terminology and International Classification of Diseases (ICD) codes. The PearlDiver database contains records for more than 22 million patients, further describing hospital and physician billing records, as well as prescription medication information. Our secondary aims were (1) to confirm previously published rates of contracture release and (2) to determine whether anticoagulant use following surgical treatment of elbow trauma is associated with an increased risk of contracture and contracture release.ĭata were collected from the Humana insurance database using the PearlDiver Patient Records Database ( from 2007 to 2017. ![]() In this study, we aimed to establish the incidence of contracture development following surgical treatment of elbow trauma using a national database. 11, 24 However, no study has yet specifically examined the relationship between anticoagulant or opioid usage and contracture following surgical treatment of elbow trauma. Additionally, recent studies have demonstrated an association between increased opioid use and poorer functional outcomes after musculoskeletal surgery. 4, 9, 21, 22 In the arthroplasty literature, patients treated with perioperative anticoagulation had an increased likelihood of developing postoperative stiffness. Recently, the correlation between anticoagulant usage and postoperative arthrofibrosis in the knee joint after total knee arthroplasty has become a topic of interest. Other investigations of outcomes after elbow trauma have studied similar risk factors, given their established associations to postoperative elbow stiffness 1, 8, 12 however, recent data from other subspecialties have identified additional factors' impacts on postoperative stiffness. ![]() The study additionally noted a protective effect of diabetes against contracture release. They also determined that risk factors for contracture release in the New York State population included severity of fracture pattern, male sex, younger age, burn, head injuries, and increased number of hospital admissions. This study demonstrated that 270 of 19,063 patients (1.4%) underwent surgical intervention for postoperative elbow contracture, 19 which represented an incidence lower than previously shown. 7, 8, 15, 16, 17 To address the difficulty of identifying a large numbers of patients within a single center, Schrumpf et al performed an epidemiologic review of the New York SPARCS database to identify patients with elbow trauma. Previous literature reports varying rates of elbow contracture after trauma based on studies of small cohorts of patients, which range between rates of roughly 3% and 20%. 14, 18 In spite of the debilitating nature of the deficits associated with decreased elbow range of motion, rates of contracture are still not well established. 3, 12 It has been demonstrated that functional elbow range of motion requires an arc of motion of roughly 30°-130° for activities of daily living such as hygiene and self-care. Post-traumatic contracture leads to decreased elbow range of motion and can result in functional impairment, restricting activities in daily life and ability to participate in preinjury profession. 13 Although directed occupational therapy and progressive early range of motion after any elbow injury can help minimize risk of contracture, a subset of patients are still plagued by decreased range of motion in spite of these modalities. Morrey postulated that the elbow is especially vulnerable to development of contracture because of its complex articular anatomy characterized by a high degree of congruency. ![]() ![]() Elbow contracture is a known complication after elbow trauma and can result from a range of injuries including fracture, dislocation, soft tissue injury, and burns. ![]()
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