External fixation about the elbow: Indications and long-term outcomes.

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Biomechanics

Background:

• Operative management of elbow fractures aims to restore stability, reduction, and early motion.
• External fixators are sometimes required for complex elbow fractures.
• Risk factors and outcomes associated with external fixator use in elbow fractures require further investigation.

Purpose of the Study:

• To identify risk factors necessitating external fixator application for elbow fractures.
• To compare elbow range of motion (ROM) and functional outcomes between patients who did and did not require external fixation.

Main Methods:

• Retrospective study of 391 patients undergoing operative management for distal humerus or proximal radius/ulna fractures.
• Analysis of risk factors for external fixator placement.
• Comparison of elbow ROM and functional scores (MEPI) between external fixator and non-external fixator groups.

Main Results:

• 26 patients (6.6%) required external fixation; 365 did not.
• Risk factors for external fixator use included higher BMI, elbow dislocation, open wounds, and additional non-contiguous orthopedic injuries.
• External fixator group showed poorer elbow extension, flexion, and pronation, and lower functional scores.

Conclusions:

• External fixation for elbow fractures is associated with more severe initial injuries.
• Patients requiring external fixation experience worse elbow range of motion and functional outcomes.
• Findings can guide surgeon-patient discussions on treatment options and prognosis.