[A hinged external fixator for treatment of complex elbow joint injuries].
BACKGROUND
The treatment of complex injuries of the elbow joint by a hinged fixator is a new concept of external transfixation with guided movement in a defined monocentric axis. Biomechanical investigations using cadaver specimens showed that the monocentric guidance ensures additional stability in these unstable osteoligamentous injuries, allows early functional treatment, and can be used in primary but also in revision surgery.


METHODS
Between 1997 and 2004, 23 patients with complex fractures of the elbow joint were treated with a hinged monocentric external fixator after open reduction and internal fixation. The early functional treatment started 6.4 days (mean) postoperatively; the average range of motion (ROM) was 58 degrees.


RESULTS
The early functional treatment using a hinged fixator resulted in a mean increase in the range of motion of up to 71 degrees within an average time course of 34.7 days. In 18 patients a significant increase in the ROM was seen; in 4 patients no improvement in the ROM could be achieved. Only one patient showed a decrease in ROM (5 degrees). Follow-up examinations after 10 months revealed a mean ROM of 88 degrees.


CONCLUSIONS
In agreement with the literature, our results provide evidence that the use of a hinged monocentric external fixator in combination with early functional therapy results in an increase in the ROM and represents a beneficial device and concept in the treatment of complex injuries of the elbow joint.
Schmickal
T
T
Klinikum Neumarkt, Nürnberger Strasse 12, 92318, Neumarkt i. d. Opf., Germany. unfallchirurgie@klinikum.neumarkt.de
Hoentzsch
D
D
Wentzensen
A
A
D004551:Elbow Joint / Q000601:surgery*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D016267:External Fixators; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D000092464:Elbow Injuries