Indications
Persistent instability despite radial head ORIF / arthroplasty, coronoid ORIF, LCL / MCL repair
Results
- 27 patients with hinged external fixation
- 128 degrees of flexion / extension
- 37% fixator-related complication
- 26% secondary surgery
- one recurrent instability
- 19 patients with hinged external fixation v 10 with elbow cross pinning
- no difference in ROM
- increased complications with external fixation
Options
Fixed external fixation
Hinged external fixation
Internal joint stabilizer
Fixed external fixation
AO surgery reference fixed external fixation
| Lateral humeral pin | Ulna pins |
|---|---|
|
Anterior to radial nerve
|
Subcutaneous border of ulna
|
Hinged external fixation
Distal humeral axis
- confirm center of rotation on lateral
- protect ulna nerve
- place guide wire in center of rotation
AO surgery reference hinged external fixator
| Lateral humeral pin | Medial humeral pin | Ulna pins |
|---|---|---|
|
Anterior to radial nerve |
Posterior to ulna nerve |
Subcutaneous border of ulna
|
Internal joint stabilizer
IJS Elbow Stabilization System
Concept
Dynamic internal fixator
Technique
Crescenzo et al JSES Rev technique PDF
Results
- 24 patients treated with IJS-E
- 1/24 redislocated - coronoid deficient
Heifner et al J Hand Surg Glob 2023
- systematic review of 171 elbow dislocations treated with IJS-E
- implant failure 4%
- recurrent instability 4%