Review of Four External Elbow Fixators

Complex elbow fractures with dislocation need careful surgical management. In this report, surgeons review hinged external fixators for complex elbow injuries. Four of these devices are currently on the market. They can be helpful in the treatment of elbow instability.

Hinged external fixators protect the joint and allow motion until the bones have healed. Features of each fixator are presented along with advantages and disadvantages.

The authors describe the frame construction for each of the four fixators. Location and direction of pins and type of motion allowed are discussed. Some fixators have more adjustment than others. In some cases the patient or therapist can adjust the amount of motion allowed.

Problems with the fixators are common. Infection around the pin or inside the joint can occur. The pins can break or come loose. Improper placement of the pins can cause a loss of bone reduction needed to heal the fracture. Ways to avoid nerve damage are offered. Precise pin insertion by the surgeon is an important key to preventing nerve injury.

Finally the authors review when to use external fixators for elbow fractures. Some examples include chronic dislocation or when a patient can't handle a long operation. Fracture along with ligament tear or major joint instability are two other reasons to consider using an external fixator.

References: Virak Tan, MD, et al. Hinged Elbow External Fixators: Indications and Uses. In Journal of the American Academy of Orthopaedic Surgeons. December 2005. Vol. 13. No. 8. Pp. 503-514.