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Hinged external fixation of the elbow - optimal axis alignment to minimize motion resistence during the movement - cadaveric study


Authors: Martin Feranec;  Radek Hart;  Tomáš Kozák
Authors‘ workplace: Department of orthopaedics and traumatology, Znojmo, Czech Rebublic ;  Ortopedicko-traumatologické oddělení nemocnice Znojmo
Published in: Úraz chir. 21., 2013, č.1

Overview

BACKGROUND:
There is a wide range of complex elbow injuries that require a hinged external fixation. The optimal hinge axis position, in the middle of the circle formed by the trochlea for application of the hinged external fixation of the elbow joint is well known. Its correct position is important for the result.

MATERIALS AND METHODS:
A hinged external fixator (Orthofix) was attached to the lateral side of 20 cadaveric elbows in 12 distinct off-axis positions in each specimen. The aim of the study was to evaluate the influence of the fixator malalignment on the constrained motion of the elbow joint. 40 N force had been applied.

RESULTS:
Aligning the fixator hinge along the optimized axis position resulted in a minimal motion reduction of the elbow joint. Malpositioning the hinge by 4 mm posterior caused in average 14° of motion limitation in flexion and by 7 mm caused 32° of limitation. 4 mm anterior malpositioning caused in average 15° of limitation of ROM and by 7 mm 31° of limitation. Malpositioning 4 mm proximal caused 24° of limitation and by 7 mm 36° of motion limitation. Distal malpositioning by 4 mm caused in average 16° motion limitation and by 7 mm caused 35° of limitation. Malpositioning the hinge 15° in inversion, eversion, intrarotation and extrarotation limited motion of the elbow joint in average of 14°.

CONCLUSION:
An optimal fixator hinge position is determine to minimize the increase in motion limitation due to fixator application.

Key words:
External Elbow Fixator, Optimal Axis of the Elbow, Cadaveric Study.


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Labels
Surgery Traumatology Trauma surgery
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