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. 2016 Jun;17(2):175-9.
doi: 10.1007/s10195-016-0395-x. Epub 2016 Feb 13.

Hinged external fixation for Regan-Morrey type I and II fractures and fracture-dislocations

Alberto Castelli  1   2 , Salvatore D'amico  3 , Alberto Combi  3   4 , Francesco Benazzo  4
Affiliations

Hinged external fixation for Regan-Morrey type I and II fractures and fracture-dislocations

Alberto Castelli et al. J Orthop Traumatol. 2016 Jun.

Abstract

Elbow fracture-dislocation is always demanding to manage due to the considerable soft-tissue swelling or damage involved, which can make an early open approach and ligamentous reconstruction impossible. The purpose of this study was to evaluate the role of elbow hinged external fixation (HEF) as a definitive treatment in patients with elbow dislocations associated with Regan-Morrey (R-M) type I and II coronoid fractures and soft-tissue damage. We treated 11 patients between 2010 and 2012 with HEF. Instability tests and standard X-ray examinations were performed before surgery and 1-3 to 3-6 months after surgery, respectively. All patients underwent a preoperative CT scan. Outcomes were assessed with a functional assessment scale (Mayo Elbow Performance Score, MEPS) that included 4 parameters: pain, ROM, stability, and function. The results were good or excellent in all 11 patients, and no patient complained of residual instability. Radiographic examination showed bone metaplasia involving the anterior and medial sides of the joint in 5 patients. HEF presented several advantages: it improves elbow stability and it avoids long and demanding surgery in particular in cases with large soft tissue damage. We therefore consider elbow HEF to be a viable option for treating R-M type I and II fracture-dislocations.

Keywords: Coronoid; Elbow fracture-dislocation; Heterotopic ossification; Hinged external fixator; Instability.

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Figures

Fig. 1
Fig. 1
HEF placement
Fig. 2
Fig. 2
Humeral bone screws placement
Fig. 3
Fig. 3
Elbow's center of rotation identification
Fig. 4
Fig. 4
Image intensifier identification of center of rotation landmarks
Fig. 5
Fig. 5
Image intensifier aids HEF placement
Fig. 6
Fig. 6
X-ray demonstrate bone metaplasia formation within the anterior capsule and collateral ligament complex
See this image and copyright information in PMC

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