Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
J Shoulder Elbow Surg. 2020 Jun;29(6):e238-e244. doi: 10.1016/j.jse.2019.12.018. Epub 2020 Mar 5.
Recently, the Internal Joint Stabilizer of the Elbow (IJS-E) was developed as an internal dynamic fixator for use in the setting of traumatic elbow instability. This study reviews the patients who had an IJS-E placed at our institution. Specifically, postoperative complications, postoperative functional outcomes, and need for subsequent procedures were reviewed.
A retrospective chart review was conducted of patients in whom the IJS-E was implanted from June 2016 to July 2018. Indications for use, range of motion at final follow-up, and the need for subsequent procedures were reviewed. Disabilities of the Arm, Shoulder, and Hand (DASH) and Broberg-Morrey scores were also obtained.
Ten IJS-E devices were implanted into 10 patients. Average length of follow-up was 13.4 months. Average flexion-extension and pronation-supination motion arcs at final follow-up were 106° and 141°, respectively. Seventy-eight percent of patients achieved >100° arcs of both flexion-extension and pronation-supination. Average DASH and Broberg-Morrey scores were 28.7 and 68.2, respectively. Four subsequent procedures were required in 4 patients: 2 contracture releases, 1 medial collateral ligament reconstruction, and 1 total elbow arthroplasty. There were no postoperative infections or nerve injuries.
The IJS-E has replaced the use of external hinged fixation at our institution. Final range of motion was consistent with that reported for terrible triad and complex elbow dislocation injuries. The IJS-E is a good option for use in patients with traumatic elbow instability, as it restores motion and function without immediate postoperative complication. However, it does not eliminate the potential for future operative intervention in these complex injuries.
最近,肘内稳定器(IJS-E)作为一种用于创伤性肘不稳定的内置动态固定器而被开发出来。本研究回顾了在我们机构接受 IJS-E 治疗的患者。具体来说,回顾了术后并发症、术后功能结果和后续治疗的需求。
对 2016 年 6 月至 2018 年 7 月期间接受 IJS-E 植入的患者进行回顾性图表审查。审查了使用指征、最终随访时的活动范围以及后续治疗的需求。还获得了上肢残疾问卷(DASH)和 Broberg-Morrey 评分。
10 例患者共植入 10 个 IJS-E 装置。平均随访时间为 13.4 个月。最终随访时的平均屈伸和旋前旋后活动弧分别为 106°和 141°。78%的患者屈伸和旋前旋后的活动弧均>100°。平均 DASH 和 Broberg-Morrey 评分为 28.7 和 68.2。4 例患者(4 例)需要进行 4 次后续手术:2 次挛缩松解术、1 次内侧副韧带重建术和 1 次全肘人工关节置换术。无术后感染或神经损伤。
IJS-E 已取代了我们机构中外部铰链固定的使用。最终的活动范围与报道的三联征和复杂肘关节脱位损伤一致。IJS-E 是治疗创伤性肘不稳定患者的一个很好的选择,因为它在没有术后即刻并发症的情况下恢复了运动和功能。然而,它并不能消除这些复杂损伤中未来手术干预的可能性。