title: Temporary joint-spanning external fixation before internal fixation of open intra-articular distal humeral fractures: a staged protocol.
abstract: BACKGROUND
  This study determined outcomes after temporary joint-spanning external fixation before internal fixation of open intra-articular distal humeral fractures.
  
  
  METHODS
  A retrospective case analysis was done of all patients who were treated between 2000 and 2008 in 3 level I trauma centers with temporary joint-spanning external fixation before internal fixation of an open intra-articular distal humeral fracture. Healing rates, complications, Disabilities of Arm, Shoulder and Hand (DASH), and Smith and Cooney outcome scores were documented.
  
  
  RESULTS
  The study included 16 patients. Mean follow-up was 35.2 months. Fractures united after an average of 5.2 months. No complications specifically related to the external fixation occurred. The DASH outcome score averaged 15.1. Although complications occurred in 12 patients (9 patients requiring surgery), 10 of 16 had an excellent/good outcome score.
  
  
  CONCLUSIONS
  Temporary joint-spanning external fixation before internal fixation of open intra-articular distal humeral fractures is a safe adjunct.
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands. p.kloen@amc.uva.nl
authors.forename: Peter
authors.initials: P
authors.lastname: Kloen
authors.forename: David L
authors.initials: DL
authors.lastname: Helfet
authors.forename: Dean G
authors.initials: DG
authors.lastname: Lorich
authors.forename: Omesh
authors.initials: O
authors.lastname: Paul
authors.forename: Kim M
authors.initials: KM
authors.lastname: Brouwer
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D005597:Fractures, Open / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D057072:Intra-Articular Fractures / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries