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ARM: a modular hinged joint for the AO tubular external fixator
Alfonso Queipo de Llano Temboury1, Rafael López Arévalo, Felipe Luna González y Enrique Queipo de Lllano Jiménez
1Servicio de Cirugía Ortopédica y Traumatología Hospital Clínico-Universitario, Virgen de la Victoria de Málaga. alfonsoqueipo@yahoo.es
Techniques in Hand & Upper Extremity Surgery
|April 22, 2006
Summary
A new hinged joint clamp converts the AO tubular external fixator into a hinged external fixator for complex elbow injuries. This innovative approach yielded excellent functional and radiographic outcomes in five patients with severe elbow instability.
Area of Science:
- Orthopaedic Surgery
- Trauma Surgery
- Biomedical Engineering
Background:
- Complex traumatic elbow lesions often lead to significant disability due to instability and stiffness.
- Standard AO tubular external fixators lack the hinged functionality required for certain severe elbow injuries.
- Existing treatments for irreparable elbow lesions may involve hinged external fixators, but their application can be complex.
Purpose of the Study:
- To describe a novel hinged joint clamp designed to convert the versatile AO tubular external fixator into a hinged external fixator.
- To evaluate the efficacy and outcomes of using this modified hinged external fixator in patients with complex elbow injuries.
Main Methods:
- A prototype hinged joint clamp was developed for easy application to the AO tubular external fixator.
- The modified hinged external fixator was applied to five patients with severe elbow injuries, including "terrible triads" and fracture-dislocations.
- Patient outcomes were assessed using the Mayo Elbow Score Scale and the Broberg and Morrey radiographic evaluation scale, with a median follow-up of 18 months.
Main Results:
- All five patients achieved excellent results, scoring 100 points on the Mayo Elbow Score Scale, with no reported elbow pain or instability.
- Median flexion was 127.5 degrees, with a median extension loss of 20 degrees. Radiographic evaluation showed Grade 0 or I in all patients.
- Two complications were noted: distal ulnar Schanz screw loosening with osteolysis and a superficial screw infection.
Conclusions:
- The novel hinged joint clamp effectively transforms the AO tubular external fixator into a functional hinged external fixator.
- This system provides a versatile and effective solution for managing severe elbow instability and soft tissue lesions, leading to excellent functional recovery.
- The clamp is easy to apply and expands the utility of the AO tubular external fixator in complex trauma cases.