Gonzalez Trevizo Gilberto A, Carter Jordan T, Castagno Christopher, Fuller John B, Pirela-Cruz Miguel
Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Science Center El Paso, Paul L. Foster School of Medicine, El Paso, TX, USA.
JSES Rev Rep Tech. 2021 Dec 30;2(2):230-237. doi: 10.1016/j.xrrt.2021.11.003. eCollection 2022 May.
Management of unstable injuries was revolutionized by the Internal Joint Stabilizer (IJS). When compared to long-term immobilization, transarticular pinning, and hinge external fixation, the IJS results in decreased complications and improved clinical outcomes. Historically, the IJS was applied via a lateral approach; however, this limited intraoperative visualization and, in some cases, resulted in increased operative times. This technical report describes a posterior approach, for IJS application. The posterior approach involves an 8- to 10-cm incision over the posterior elbow through the deep fascia before identifying the olecranon and lateral capitellum, then proceeding with IJS application through manufacturer instructions. The ulnar and radial nerves must be identified as they could be damaged in this approach. Using the posterior approach at our institution, we have noticed a possible decrease in operative times and an increase in intraoperative visualization of the elbow without a subsequent increase in complications.
关节内稳定器（IJS）彻底改变了不稳定损伤的治疗方式。与长期固定、经关节穿针和铰链式外固定相比，IJS可减少并发症并改善临床结果。从历史上看，IJS是通过外侧入路应用的；然而，这限制了术中视野，在某些情况下还导致手术时间延长。本技术报告描述了一种用于应用IJS的后入路。后入路包括在肘后部做一个8至10厘米的切口，穿过深筋膜，然后识别尺骨鹰嘴和肱骨小头外侧，接着按照制造商说明进行IJS应用。必须识别尺神经和桡神经，因为在这种入路中它们可能会受损。在我们机构使用后入路时，我们注意到手术时间可能会减少，肘部的术中视野会增加，且并发症不会随之增加。
