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Treatment of Traumatic Elbow Instability with an Internal Joint Stabilizer
Kristen M. Meier, MD, MS; Steven M. Andelman, MD; Steven M. Koehler, MD; Michael R. Hausman, MD
Mount Sinai School of Medicine, New York, NY

INTRODUCTION
Current options for treating persistent elbow instability associated with complex elbow fracture-dislocations include splint or cast immobilization, transarticular cross-pinning, temporary bridge plating, and hinged or rigid external fixation. The recent development of an 'internal joint stabilizer', acting as an internal "external fixator" allows for early ulnohumeral range of motion while maintaining a stable and congruent reduction of the ulnohumeral and radiocapitellar joints.

MATERIALS and METHODS
This retrospective study reviewed ten patients who underwent placement of a modified internal joint stabilizer for persistent elbow instability after severe elbow fracture-dislocations. Final post-operative range of motion and complication rates were monitored for all patients and five patients completed outcome-scoring questionnaires.

RESULTS
Ten patients who underwent placement of an internal joint stabilizer for persistent elbow instability after fracture-dislocation were reviewed. The final post-operative flexion-extension arc was 113 24.2. When controlling for two uniquely complex patients, the final post-operative arc of motion improved to 124.3 11.0. The average Mayo Elbow Performance Score improved from 10 11.2 to 64 21.4 while the average Disabilities of Arm, Shoulder, and Hand score improved from 97.8 2.5 to 40.5 34.7.

CONCLUSIONS
Use of an internal joint stabilizer allows for early, congruent, and stable ulnohumeral and radiocapitellar range of motion in instances of persistent elbow instability after elbow fracture-dislocation.




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