Universität zu Köln

Leschinger, T., Ott, N., Hackl, M., Wegmann, K. and Mueller, L. P. (2020). External fixator of the elbow. Oper. Orthopade Traumatol., 32 (5). S. 387 - 396. MUNICH: URBAN & VOGEL. ISSN 1439-0981

Full text not available from this repository.

Abstract

Aim of surgery The placement of an external elbow fixator can be statically carried out as temporary stabilization or as a hinged movement fixator. As a hinged movement fixator a functional follow-up treatment is possible due to control of the joint guidance and reduction of the compromising forces on the osteoligamentous structures. Indications As a temporary stabilization of the elbow, the external fixator is used as a damage control method. As a movement fixator it is used as an additional protection and movement control after complex osteoligamentous interventions and persisting tendency to dislocation of the joint and also as a standalone procedure. In some cases, the procedure is also used in distraction arthrolysis of stiff elbows and as a salvage procedure in patients with relevant comorbidities as part of fracture treatment. Contraindications Inexperience in relation to the procedure as well as a local acute infection at the level of the intended pin locations should specifically be mentioned as contraindications. In addition, compliance and patient understanding of the procedure are essential for the success of treatment. Surgical technique Soft tissue preparation for pin placement should be preferred over percutaneous incisions to enable a safe bone exposure. Knowledge of the course of neurovascular structures (particularly the radial nerve) is essential. When placing a hinge, knowledge of the position and detection of the idealized center of rotation is of fundamental importance. Postoperative management The type of postoperative management required essentially depends on the underlying injury. When placing a hinged fixator, the aim is to enable movement as early as possible. Nevertheless, blocking of the hinged fixator may be useful for a short period of time. Adequate pin care over the duration of the treatment is essential in order to prevent complications. Results Good functional results have been reported for the treatment of unstable elbows after primary and secondary placement of a hinged external fixator. Good functional scores and improvement in the range of motion were also recorded in the context of an arthrolysis (additive for open arthrolysis or distraction arthrolysis); however, in contrast a significant number of complications associated with this surgery are likely to emerge. As a definitive salvage procedure, satisfactory results were obtained in a small case series of a selected older patient group with relevant comorbidities.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leschinger, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ott, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-318752
DOI:	10.1007/s00064-020-00676-6
Journal or Publication Title:	Oper. Orthopade Traumatol.
Volume:	32
Number:	5
Page Range:	S. 387 - 396
Date:	2020
Publisher:	URBAN & VOGEL
Place of Publication:	MUNICH
ISSN:	1439-0981
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FRACTURE-DISLOCATION; COMPLEX INSTABILITY; ROTATION AXIS; RADIAL NERVE; COMPLICATIONS; MANAGEMENT; ACCURACY Multiple languages Orthopedics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31875