Wang Hong Meng Chunqing Duan Deyu Yang Shuhua Ye Shunan Shao Zengwu Department of Orthopedics, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology Wuhan 430022 Abstract: OBJECTIVE: To investigate the effect of arthroscopic release of elbow stiffness. Materials and Methods: 15 patients with elbow stiffness, 13 males and 2 females, 6 cases of left elbow and 11 cases of right elbow. The duration of the disease ranged from one year to five years, with no effect through conservative treatment, including seven cases of supracondylar fracture, two cases of fall dislocation, four cases of throwing sports injury, and two cases of unknown cause. preoperative elbow mobility ranged from negative 20° to 45° in extension, with an average of negative 35°, and from 60° to 135° in flexion, with an average of 98.75°. the contracted joint capsule and adherent fibers of the anterior elbow joint were released under elbow arthroscopy, and the hyperplastic bone flab was The contracted capsule and adherent fibers in the anterior part of the elbow joint were released under elbow arthroscopy, and the hyperplastic bone fragments were excised and removed. Postoperatively, the elbow was immobilized with an extension brace, and flexion and extension exercises were started on the first day. Results: The postoperative elbow mobility was 0° in extension and 120° to 140° in flexion, with a mean of 132.5°. After 6-month follow-up, elbow joint activity returned to normal with no rebound. Conclusion: Arthroscopic release in joint stiffness is practical, can achieve good results, and can replace the traditional method of elbow joint release. Wang Hong, Department of Orthopedics, Wuhan Union Hospital Preface Injuries to the elbow joint such as supracondylar humerus fracture and elbow dislocation have been treated by manipulation or surgery, and some patients develop stiffness of the elbow joint. Previous treatments have had manipulation for release, which often leads to new injuries such as re-fracture. Surgical incision for release results in a large incision, significant injury, and slow postoperative recovery. In contrast, arthroscopic release surgery has a small incision, little damage, and a quick postoperative recovery. We have performed arthroscopic release in 4 cases and achieved good treatment results, which is worth promoting. Materials and methods Clinical treatment: 15 patients with elbow stiffness, 13 males and 2 females, 6 cases of left elbow and 11 cases of right elbow. The duration of the disease was one year to five years, and there was no effect through conservative treatment, including seven cases of supracondylar fracture, two cases of fall dislocation, four cases of throwing sports injury, and two cases of unknown cause. preoperative elbow mobility was, negative 20° to 45° for extended elbow, mean negative 35°, and 60° to 135° for flexed elbow, mean 98.75. elbow arthroscopic release of elbow joint: arthroscopy was knee arthroscopy, and the anterolateral access point of elbow joint was taken to puncture The arthroscope was first injected with 20 ml of saline, incised, separated and placed, and the ulnar coronoid process of the elbow joint or the articular surface of the radial tuberosity was seen microscopically to confirm that the arthroscope was inside the joint cavity. The arthroscope was passed out from the anteromedial side of the elbow joint to the subcutis from the outside inwards, and the skin was incised and bluntly separated under arthroscopic guidance to the joint cavity. Under arthroscopic monitoring, a planing knife is used to clean up the adherent fibers and scars, a grinding drill is used to grind away the hyperplastic bone, the free body is removed, and a plasma knife is used to release the contracted joint capsule anterior to the elbow joint. At this point, manipulation can be performed for release. If this is not possible, the arthroscope is then inserted from the posterior lateral side of the elbow joint, followed by a posterior medial approach to shape the hawk’s nest. After the arthroscopic release, the elbow joint is flexed and extended until the elbow joint flexion and extension are normal. Postoperatively, a drainage tube was issued in the joint cavity and immobilized in an extension brace. Elbow flexion and extension activities were started on the first postoperative day. Results The postoperative elbow mobility was 0° for both extension and 120° to 140° for flexion, with a mean of 132.5°. After 6-month follow-up, elbow joint activity recovered well without rebound. Discussion Elbow stiffness is a joint contracture caused by fractures, dislocations and burns of the elbow joint, with elbow extension greater than 30°, and or flexion less than 120°, which affects the patient’s life. There is a 50% reduction in elbow joint motion and 80% loss of upper extremity function. Surgical treatment of elbow stiffness is a challenge. Limited open surgery is safe and effective, with improvement of 50-70 degrees in approximately 80-90% of patients. Arthroplasty surgery is available for severe articular surface damage, and only elbow stiffness older than 65 years of age requires arthroplasty. Arthroscopic treatment of elbow stiffness has been limited by concerns about damage to blood vessels and nerves. Recently, some authors have performed arthroscopic release of elbow stiffness with good results. We performed arthroscopic release of elbow stiffness in 15 cases, and all patients had excellent results, and elbow motion returned to normal. There was no vascular or nerve injury in all patients. We believe that arthroscopic release of the elbow joint should be performed with experience in elbow arthroscopic treatment and with a learning process. Preoperatively, a thorough evaluation of the patient’s imaging data is required to develop a treatment plan. During the operation, the hyperplastic bones and free bodies should be removed, and the joint capsule and the hyperplastic scar tissue in the anterior part of the elbow joint should be released. When performing manual release, be gentle and careful of fractures. Postoperative drains should be placed to avoid blood accumulation in the joint cavity and re-adhesion. Postoperative rehabilitation exercises are important. We fixed the elbow joint with an extension brace after surgery, started functional exercises on the first day after surgery, and took oral medication to prevent ossifying myositis after surgery. In general, patients are encouraged to take the initiative to perform functional exercises of the elbow joint. All patients were able to return to normal range of motion. Arthroscopic elbow release is practical, minimally invasive, relatively safe, allows early functional exercise, and has a small surgical incision with no possibility of incisional scar contracture.