Heifner John J, Chambers Lori R, Halpern Abby L, Mercer Deana M
Miami Orthopaedic Research Foundation, Coral Gables, FL.
Larkin Hospital Department of Orthopedic Surgery, Coral Gables, FL.
J Hand Surg Glob Online. 2023 Oct 11;6(1):62-67. doi: 10.1016/j.jhsg.2023.09.004. eCollection 2024 Jan.
The goal of surgical management for unstable elbow injuries is the restoration of joint concentricity and stability. After internal fixation, concerns may exist regarding instability or durability of the fixation construct. Historically, these scenarios were treated with options such as transarticular pinning or external fixation. Recently, an internal joint stabilizer (IJS) that allows postoperative mobilization was introduced. Our objective was to systematically review the literature to aggregate the clinical and biomechanical evidence for the IJS of the elbow.
A systematic review of the PubMed and Google Scholar databases was performed, following the PRISMA guidelines. The search results were narrowed from 2015 through 2023 to coincide with the inception of the device being reviewed.
A total of nine retrospective reports on the IJS ( = 171) cases at a mean follow-up of 10.8 months were included. The pooled rate of implant failure was 4.4%, and recurrent instability was 4.1%. Additionally, the we included seven case reports and two biomechanical reports.
The aggregate literature describes satisfactory clinical outcomes with low rates of recurrent instability and device failure for the IJS of the elbow. The limited biomechanical investigations conclude efficacy for stability profiles.
Across a spectrum of unstable elbow cases, the IJS prevented recurrent instability during the early postoperative period. Notably, the device requires an additional procedure for removal, and the long-term impact of the retained devices is currently unclear.
不稳定肘关节损伤的手术治疗目标是恢复关节同心度和稳定性。内固定后，可能会担心固定结构的稳定性或耐用性。从历史上看，这些情况采用经关节穿针或外固定等方法治疗。最近，一种允许术后活动的关节内稳定器（IJS）被引入。我们的目的是系统回顾文献，汇总肘关节IJS的临床和生物力学证据。
按照PRISMA指南对PubMed和谷歌学术数据库进行系统回顾。搜索结果从2015年到2023年进行筛选，以与所审查设备的引入时间一致。
共纳入9篇关于IJS（n = 171）病例的回顾性报告，平均随访10.8个月。植入物失败的汇总率为4.4%，复发性不稳定为4.1%。此外，我们还纳入了7篇病例报告和2篇生物力学报告。
汇总文献描述了肘关节IJS令人满意的临床结果，复发性不稳定和设备失败率较低。有限的生物力学研究得出了稳定性方面的有效性结论。
在一系列不稳定肘关节病例中，IJS在术后早期预防了复发性不稳定。值得注意的是，该设备需要额外的手术进行取出，目前保留设备的长期影响尚不清楚。
