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Related Experiment Videos

Hinged elbow external fixation for severe elbow contracture.

David Ring1, Robert N Hotchkiss, Daniel Guss

  • 1Massachusetts General Hospital, ACC 525, 15 Parkman Street, Boston, MA 02114, USA. dring@partners.org

The Journal of Bone and Joint Surgery. American Volume
|June 3, 2005
PubMed
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Hinged external fixation for severe elbow contractures offers minimal gains in motion compared to standard treatment. The increased risks and complications outweigh the slight benefits, making it not recommended.

Area of Science:

  • Orthopedic surgery
  • Reconstructive surgery
  • Biomechanics

Background:

  • Hinged external fixation was introduced to improve elbow range of motion after contracture release.
  • The device aimed to provide passive motion and static progressive stretch via a gear mechanism.
  • It was hypothesized to enhance ulnohumeral motion by gradually stretching contracted muscles.

Purpose of the Study:

  • To evaluate the efficacy of hinged external fixation in improving elbow range of motion.
  • To compare outcomes of patients treated with and without hinged external fixation after contracture release.
  • To assess the risks and complications associated with hinged elbow fixation.

Main Methods:

  • A retrospective study of 42 patients with severe posttraumatic elbow contractures (motion <= 40 degrees).

Related Experiment Videos

  • 23 patients received hinged external fixation with a worm gear for static progressive stretch.
  • 19 patients were treated without hinged external fixation; operative techniques remained consistent.

    • Main Results:

    • Average gain in range of motion was 89 degrees with the hinge versus 78 degrees without.
    • This difference was statistically insignificant (p = 0.175).
    • Complications included pin-track infections, osteomyelitis, ulnar fracture, broken screws, and ulnar nerve irritation.

    Conclusions:

    • Open release of severe elbow contractures yields substantial motion gains regardless of fixation method.
    • The marginal improvement from hinged fixation does not justify its associated risks, costs, and complications.
    • Standard treatment without hinged external fixation is recommended for severe elbow contractures.