Ligament injury and the use of hinged external fixators at the elbow

The indications and techniques for managing collateral ligament deficiencies after traumatic elbow injuries are continuing to evolve. Essentially, the lateral collateral ligament must be repaired, whereas the medial collateral ligament will heal in some instances. The repair of the medial collateral ligament is needed only in competitive athletes who place high valgus stress on the elbow joint. An understanding of the role of external fixators is also evolving. External fixation is effective in managing acute elbow trauma that results in an unstable elbow and reconstructive procedures in which the collateral ligaments or articular surface require protection in circumstances requiring movement of the elbow joint. Using half pins and a laterally placed external fixator provides the mechanical stability required in most traumatic settings.