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. 2021 Mar 1;35(3):e82-e88.
doi: 10.1097/BOT.0000000000001876.

Static and Dynamic External Fixation are Equally Effective for Unstable Elbow Fracture-Dislocations

Saad AlQahtani  1 , William R Aibinder  2 , Joshua A Parry  3 , Anna Seltser  4 , George S Athwal  4 , Graham J W King  4 , Scott P Steinmann  5 , Kenneth J Faber  4
Affiliations

Static and Dynamic External Fixation are Equally Effective for Unstable Elbow Fracture-Dislocations

Saad AlQahtani et al. J Orthop Trauma. .

Abstract

Objective: To compare the clinical outcomes of static versus dynamic external fixation for elbow fracture-dislocations with persistent instability after surgical management.

Design: Comparative, retrospective review.

Setting: Two tertiary referral upper-extremity centers.

Patients: Twenty-four elbows requiring external fixation for persistent elbow instability within 90 days of surgical management of an elbow fracture-dislocation.

Intervention: Static and dynamic external fixation was used in 16 and 8 patients, respectively, for a median of 39 days (interquartile range, 33-48 days).

Main outcome measurements: Elbow range of motion, complications, and revision surgeries.

Results: Immediately after static and dynamic external fixation removal, there was no difference in elbow extension [33 degrees ± 16 degrees vs. 41 degrees ± 13 degrees, mean difference (MD) 7 degrees, 95% confidence interval (CI) -6 degrees-22 degrees] or flexion (114 degrees ± 35 degrees vs. 118 degrees ± 11 degrees, MD 4 degrees, 95% CI -23 degrees-132 degrees), respectively. At last follow-up, static and dynamic external fixation groups had no difference in elbow extension (27 degrees ± 13 degrees vs. 24 degrees ± 10 degrees, MD -3 degrees, 95% CI -15 degrees-7 degrees) or flexion (129 degrees ± 12 degrees vs. 128 degrees ± 14 degrees, MD -1 degree, 95% CI -13 degrees-10 degrees), respectively. Static and dynamic external fixation groups had no difference in complications [7 (44%) vs. 5 (63%), difference 19%, 95% CI -23%-54%] or revision surgeries [6 (38%) vs. 4 (50%), difference 13%, 95% CI -27%-49%].

Conclusions: No difference in range of motion, complications, and revision surgeries was detected after static versus dynamic external fixation of persistently unstable elbow fracture-dislocations. Due to ease of application, static external fixation is our preferred treatment for these injuries.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

G. S. Athwal receives royalties from Wright Medical and Exactech; G. J. W. King receives royalties from Wright Medical; S. P. Steinmann receives royalties from Zimmer-Biomet and Arthrex; K. J. Faber receives royalties from Exactech. The remaining authors report no conflict of interest.

References

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