title: Treatment of unstable elbow dislocations with hinged elbow fixation-subjective and objective results.
abstract: BACKGROUND
  The aim of this study was to provide subjective and objective results of surgical treatment of unstable elbow dislocations with the hinged external fixation technique.
  
  
  METHODS
  Twenty-six patients were available for re-examination after treatment. Parameters used to quantify the subjective functional results were the Mayo Elbow Performance Score, the shortened Disabilities of the Arm, Shoulder, and Hand questionnaire, and the stability of the elbow joint. In addition, we measured the medial and lateral joint space by varus and valgus stress ultrasound examinations of the elbow.
  
  
  RESULTS
  The mean Mayo Elbow Performance Score was 93.5 (±8.3 standard deviation), and the shortened Disabilities of the Arm, Shoulder, and Hand questionnaire showed an average of 7.3 points (±8.9 standard deviation). We saw 18 patients with stable joints and 8 patients with slight instability. In the ultrasound stress test, we saw a significant difference of the affected joint under varus stress (7.8 ± 1.7 mm) compared with the healthy joint (5.8 ± 1.2 mm) laterally. Furthermore, medially the gap was significantly larger (4.8 ± 0.9 mm; treated elbow) than contralaterally under valgus stress (3.3 ± 0.7 mm) (P < .001).
  
  
  CONCLUSIONS
  Closed reduction and hinged external fixation of unstable elbow dislocations resulted in good and very good results. We could identify a slight difference in the stability of the affected elbow compared with the contralateral side in all patients without clinical relevance.
authors.affiliation: Chirurgische Klinik, St. Elisabeth Krankenhaus, Köln, Germany.
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Hopf
authors.affiliation: Chirurgische Klinik, St. Elisabeth Krankenhaus, Köln, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Berger
authors.affiliation: Chirurgische Klinik, St. Elisabeth Krankenhaus, Köln, Germany.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Krieglstein
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Köln, Germany.
authors.forename: Lars P
authors.initials: LP
authors.lastname: Müller
authors.affiliation: Chirurgische Klinik, St. Elisabeth Krankenhaus, Köln, Germany. Electronic address: tkoslowsky@web.de.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Koslowsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016267:External Fixators; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011403:Pronation; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013484:Supination; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: Elbow dislocation; external fixation; ultrasound