Use of distraction arthroplasty in unstable fracture dislocations of the elbow

Patients with persistent instability after experiencing posterior dislocation of the ulnohumeral joint associated with large unstable fractures of the coronoid process of the ulna can be challenging to manage. To date, no reports have documented an effective treatment program for this injury. Joint stiffness or persistent instability results in most cases. Seven patients are discussed who were treated with a joint distraction device. Six (86%) of the 7 patients had successful outcomes at a minimum followup of 2 years. The mean arc of flexion before surgery was 33 degrees; after surgery, the arc increased to 88 degrees. The joint distraction device provides immobilization of periarticular fractures and simultaneously allows for joint movement, which results in a stable and mobile joint. Without this device, a 20% satisfactory result for this injury was reported; this percentage improved to 86% by rendering the joint stable with adequate motion.