Vishnu C Potini1, Shade Ogunro1, Patrick D G Henry1, Irfan Ahmed1, Virak Tan2. 1. Department of Orthopaedics, Rutgers University-New Jersey Medical School, Newark, NJ; Hand and Upper Extremity Center, Dallas, TX; Department of Surgery, Division of Orthopaedics, University of Toronto-Sunnybrook Health Science Center, Toronto, Ontario, Canada. 2. Department of Orthopaedics, Rutgers University-New Jersey Medical School, Newark, NJ; Hand and Upper Extremity Center, Dallas, TX; Department of Surgery, Division of Orthopaedics, University of Toronto-Sunnybrook Health Science Center, Toronto, Ontario, Canada. Electronic address: tanvi@njms.rutgers.edu.
Abstract
PURPOSE: To evaluate the outcomes of patients who underwent application of hinged external fixators for chronic elbow fracture-dislocations. We hypothesized that patients treated for this injury pattern can achieve satisfactory outcomes but encounter many complications and require numerous additional procedures. METHODS: We performed a retrospective review of 7 patients who were surgically treated with application of a hinged external fixator for chronic ulnohumeral elbow fracture-dislocation. Patients were included only if they had complete ulnohumeral dislocation of greater than 1 month's duration. Demographics, injury pattern, and range of motion were documented. Preoperative and postoperative range of motion was recorded and any treatment complications or additional surgeries were noted. RESULTS: The interval between the initial injury and index procedure averaged 8 months. All patients underwent initial treatment with open reduction internal fixation. Average arc of ulnohumeral motion improved from 26° (range, 0° to 60°) to 120° (range, 100° to 145°). Overall, 4 of 7 patients developed at least one complication during treatment. Three patients required additional procedures aside from removal of the hinged external fixator. These 3 patients underwent a total of 13 additional procedures. CONCLUSIONS: Although patients can achieve good outcomes, realistic expectations should be set. Patients should be aware that surgery can be associated with a high risk of complications, potential treatment failure, and a need for additional surgical procedures. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: To evaluate the outcomes of patients who underwent application of hinged external fixators for chronic elbow fracture-dislocations. We hypothesized that patients treated for this injury pattern can achieve satisfactory outcomes but encounter many complications and require numerous additional procedures. METHODS: We performed a retrospective review of 7 patients who were surgically treated with application of a hinged external fixator for chronic ulnohumeral elbow fracture-dislocation. Patients were included only if they had complete ulnohumeral dislocation of greater than 1 month's duration. Demographics, injury pattern, and range of motion were documented. Preoperative and postoperative range of motion was recorded and any treatment complications or additional surgeries were noted. RESULTS: The interval between the initial injury and index procedure averaged 8 months. All patients underwent initial treatment with open reduction internal fixation. Average arc of ulnohumeral motion improved from 26° (range, 0° to 60°) to 120° (range, 100° to 145°). Overall, 4 of 7 patients developed at least one complication during treatment. Three patients required additional procedures aside from removal of the hinged external fixator. These 3 patients underwent a total of 13 additional procedures. CONCLUSIONS: Although patients can achieve good outcomes, realistic expectations should be set. Patients should be aware that surgery can be associated with a high risk of complications, potential treatment failure, and a need for additional surgical procedures. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors: Bart Van Tunen; Esther M M Van Lieshout; Konrad Mader; Dennis Den Hartog Journal: Eur J Trauma Emerg Surg Date: 2022-06-25 Impact factor: 3.693