ABSTRACT
The authors report their experience of treating complex elbow fracture-dislocations in elderly people, using a minimally-invasive approach with a new articulated external fixator that is associated with minimal internal fixation. The clinical results for 19 patients are presented according to outcome factors, such as range of motion, pain and function, rate and type of complications, and reoperation rate. The results indicate that this treatment strategy should be considered as a good alternative to other treatment options reported in the literature, including conservative treatment, ORIF with angular stable plates and total elbow arthroplasty.
Subject(s)
Elbow Joint/surgery , External Fixators , Fracture Fixation , Fractures, Bone/surgery , Joint Dislocations/surgery , Osteoporosis/surgery , Aged , Disability Evaluation , Female , Follow-Up Studies , Fracture Fixation/instrumentation , Fractures, Bone/physiopathology , Fractures, Bone/rehabilitation , Humans , Joint Dislocations/physiopathology , Joint Dislocations/rehabilitation , Male , Osteoporosis/complications , Osteoporosis/physiopathology , Prospective Studies , Quality of Life , Range of Motion, Articular , Treatment Outcome , Elbow InjuriesABSTRACT
The authors report 40 patients affected with diaphyseal fracture of the humerus treated by dynamic axial fixator (FAD Orthofix). Minimum follow-up was 2 years. A clinical and radiographic retrospective study was conducted with the purpose of verifying the validity of external fixation as treatment of choice in diaphyseal fractures of the humerus. The results were evaluated considering healing time, extent and type of complications, long-term clinical, radiographic and functional findings. Results were: excellent: 35; good: 2; fair: 2; poor: 1. Complications were: nonunione: 1; reimplantation of FAD screws: 1; 4 infections of the screw holes, 3 realignments due to secondary displacement, 1 re-fracture after removal of the implant. There were no iatrogenic lesions of the radial nerve, or infections of the fracture site. The authors conclude that this semi-invasive, versatile and well-tolerated method, may be considered a valid alternative to conservative treatment, or to internal fixation even in cases of single trauma, despite limits related to the degree of collaboration of the patient, particularly with regard to debridement of the screw holes and periodical clinical and radiographic monitoring.
