Restoration of function in the knee and elbow with a hinge-distractor apparatus.

External hinged distraction devices using transosseous pins and adjustable attachments were applied to mobilize joint contractures; to reduce old dislocations; and to reduce, immobilize, and compress ununited para-articular fractures. Once these procedures were accomplished the devices were then used to maintain the joint surfaces separated at predetermined distances while kinematically normal joint motion was gradually restored, first passively and then actively. The results in thirty-one knees and twenty-eight elbows treated with these devices were encouraging after follow-ups of one to six years.