Post-traumatic elbow stiffness in adolescents: open vs. arthroscopic management and comparison with adults.

Background: Post-traumatic elbow stiffness in adolescents is a complex challenge that requires individualized treatment approaches. While open arthrolysis remains the most commonly used technique, arthroscopic techniques have emerged as a promising alternative with potential advantages in this younger population. This narrative review aims to emphasize the advantages of arthroscopic arthrolysis over the open approach in the adolescent patient. In addition, we explore how differences in etiology, diagnostic evaluation, and treatment response between adolescents and adults influence decision-making and outcomes. Methods: A narrative review of the current literature on post-traumatic elbow stiffness in adolescents was conducted. Clinical studies, previous reviews, and recent advancements were analyzed. Clinical examples from our center were also presented. Results: Arthroscopic arthrolysis was associated with improved range of motion, faster recovery, and lower complication rates in selected patients. However, open arthrolysis remains superior in cases with severe deformity, heterotopic ossification, or prior surgical history. In our experience, the indications for arthroscopic arthrolysis can be expanded when performed by experienced surgeons. Conclusion: Even though open arthrolysis remains the gold standard for complex elbow stiffness, arthroscopic approaches show promising outcomes in adolescents and could be used more widely in centers with sufficient expertise.