T Schmickal1, D Hoentzsch, A Wentzensen. 1. Klinikum Neumarkt, Nürnberger Strasse 12, 92318, Neumarkt i. d. Opf., Germany. unfallchirurgie@klinikum.neumarkt.de
Abstract
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. PATIENTS AND 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. CONCLUSION: 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.
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. PATIENTS AND 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. CONCLUSION: 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.
Authors: Hans Clement; Wolfgang Pichler; Norbert Peter Tesch; Nima Heidari; Wolfgang Grechenig Journal: Surg Radiol Anat Date: 2009-10-06 Impact factor: 1.246
Authors: A Moghaddam-Alvandi; E Dremel; F Güven; V Heppert; C Wagner; S Studier-Fischer; P A Grützner; B Biglari Journal: Unfallchirurg Date: 2010-04 Impact factor: 1.000
Authors: Niels W L Schep; Jeroen De Haan; Gijs I T Iordens; Wim E Tuinebreijer; Maarten W G A Bronkhorst; Mark R De Vries; J Carel Goslings; S John Ham; Steven Rhemrev; Gert R Roukema; Inger B Schipper; Jan Bernard Sintenie; Hub G W M Van der Meulen; Tom P H Van Thiel; Arie B Van Vugt; Egbert J M M Verleisdonk; Jos P A M Vroemen; Philippe Wittich; Peter Patka; Esther M M Van Lieshout; Dennis Den Hartog Journal: BMC Musculoskelet Disord Date: 2011-06-09 Impact factor: 2.362