title: Long-term results after Ilizarov treatment for severe high-energy injuries of the elbow.
abstract: BACKGROUND
  Clinical aspects, such as the long-term results after circular external fixation and functional rehabilitation after high-energy injuries of the elbow joint, have not received sufficient attention in the literature.
  
  
  METHODS
  Fourteen patients with high-energy elbow injuries were treated in our hospital over the last 15 years with a circular external fixation frame. The mechanism of injury was blast in eight patients, gunshot wounds in two, motor vehicle crash in two, and fall from height in two. Twelve patients had high-energy open periarticular fractures, nine had Gustillo-Anderson 3B fractures, and three had Gustillo-Anderson 3C fractures. Two patients suffered from closed high-energy periarticular elbow injuries. Seven patients had associated peripheral neurologic injuries and three had vascular injuries. Average Ilizarov fixation time was 20 weeks (range, 6-47 weeks).
  
  
  RESULTS
  The follow-up period varied from 1.5 years to 11 years. The average arc of elbow flexion was 110.4 degrees and extension was 19.6 degrees. The average arc of forearm rotation was of 63.5 degrees for pronation (range, 5-90 degrees) and 63.2 degrees for supination (range, 5-90 degrees). The average Mayo Elbow Performance Index score was 84 points (range, 60-100) and the average Khalfayan functional score was 83.4 (range, 68.7-100).
  
  
  CONCLUSIONS
  Long-term follow-up proved that the hinged Ilizarov/hybrid frame represents a useful instrument to provide stabilization of the elbow joint while facilitating early movements and physiotherapy. The main indication is patients who suffered from open high-energy contaminated fractures with extensive soft-tissue damage (e.g., blast, war injuries) and combined bone and ligaments injuries.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Lucian
authors.initials: L
authors.lastname: Fodor
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Ullmann
authors.forename: Michael
authors.initials: M
authors.lastname: Soudry
authors.forename: Alexander
authors.initials: A
authors.lastname: Lerner
mesh_terms: D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008875:Middle Aged; D020127:Recovery of Function; D055815:Young Adult; D000092464:Elbow Injuries