[Complex osteoligamentary injuries of the elbow. Treatment with a hinged external fixator]. / Komplexe osteoligamentäre Verletzungen des Ellenbogens. Therapie mit dem Bewegungsfixateur externe.

BACKGROUND: Hinged external fixation is a recognized method to treat instabilities after complex dislocations and fracture-dislocations of the elbow. The hinged external fixator allows stabilization of the elbow while preserving flexion and extension. METHODS: Eighteen patients with an average age of 47 years (range 35-67) were treated with a hinged external fixator between April 2001 and March 2006 for 6 weeks. In 11 patients an internal fixation had to be done; six were treated initially with an AO fixator. After 8 days (3-14), we changed to a hinged external fixator. RESULTS: At 39 months (12-71) of follow-up, all 18 elbows were stable. One stress-fracture of the ulna after pin removal occurred. The mean Mayo Elbow Performance Index (MEPI) was 78 points. Five (28%) patients had an excellent result, six (33%) a good result and seven (39%) a fair result. The average DASH score (disabilities of the arm, shoulder and hand) was 18 points, which indicates a discrete impairment. CONCLUSION: The treatment outcome of complex instabilities treated with a hinged external fixator using our technique is comparable to outcomes from other studies.