Treatment of posttraumatic elbows with a new hinge-distractor

A simple design of elbow hinge distractor for the restoration of joint function in contractures, ankyloses, persistent dislocations, and nonunions is presented. Soft tissue releases and reshaping of joint surfaces is carried out surgically as required. Obtaining motion and stability is achieved with side plates attached to external fixation pins, one of which passes through the axis of rotation of the joint and about which flexion takes place. Distraction is obtained by a screw that separates the ulnar side plates from the humeral side plates. To aid in accurately placing the axis of rotation pin at surgery, a study was done to determine the best fit axis of rotation and how it relates to boney landmarks. One case of an ankylosed elbow is presented in detail, including the surgical technique. This and other previous cases have shown that good clinical results can be achieved in these otherwise poorly functioning elbows. Key index words: Elbow, Biomechanics.