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Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months

Background and purpose The current surgical treatment for displaced fracture of the capitellum and trochlea is open reduction and internal fixation (ORIF), but the results are often unsatisfactory, particularly with complex fractures. Furthermore, the surgical approach, the kind of osteosynthesis, a...

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Autores principales: Giannicola, Giuseppe, Sacchetti, Federico M, Greco, Alessandro, Gregori, Giuseppe, Postacchini, Franco
Formato: Texto
Lenguaje:English
Publicado: Informa Healthcare 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895343/
https://www.ncbi.nlm.nih.gov/pubmed/20180722
http://dx.doi.org/10.3109/17453671003685475
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author Giannicola, Giuseppe
Sacchetti, Federico M
Greco, Alessandro
Gregori, Giuseppe
Postacchini, Franco
author_facet Giannicola, Giuseppe
Sacchetti, Federico M
Greco, Alessandro
Gregori, Giuseppe
Postacchini, Franco
author_sort Giannicola, Giuseppe
collection PubMed
description Background and purpose The current surgical treatment for displaced fracture of the capitellum and trochlea is open reduction and internal fixation (ORIF), but the results are often unsatisfactory, particularly with complex fractures. Furthermore, the surgical approach, the kind of osteosynthesis, and postoperative management are controversial. We evaluated the results of internal fixation combined with hinged external fixation. Methods We analyzed 15 patients with a mean age of 47 (18–65) years. Based on the Bryan-Morrey-McKee classification, the fractures were identified as type I in 6 cases and type IV in 9. Active and passive motion was started and activities of daily living were permitted on the second postoperative day. The mean follow-up time was 29 (12–49) months. Results In 13 cases, functional range of motion was obtained within 6 weeks of surgery. At final follow-up, 14 patients had a stable, pain-free elbow with a mean active range of motion of 13° to 140°. The average score on the Mayo elbow performance score was 98. Interpretation The use of the hinged fixator allows early motion of the elbow while preserving joint stability. It may have additional value in complex articular fractures when stable internal fixation cannot be obtained with ORIF, and in the presence of severe ligamentous injuries.
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spelling pubmed-28953432010-09-03 Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months Giannicola, Giuseppe Sacchetti, Federico M Greco, Alessandro Gregori, Giuseppe Postacchini, Franco Acta Orthop Research Article Background and purpose The current surgical treatment for displaced fracture of the capitellum and trochlea is open reduction and internal fixation (ORIF), but the results are often unsatisfactory, particularly with complex fractures. Furthermore, the surgical approach, the kind of osteosynthesis, and postoperative management are controversial. We evaluated the results of internal fixation combined with hinged external fixation. Methods We analyzed 15 patients with a mean age of 47 (18–65) years. Based on the Bryan-Morrey-McKee classification, the fractures were identified as type I in 6 cases and type IV in 9. Active and passive motion was started and activities of daily living were permitted on the second postoperative day. The mean follow-up time was 29 (12–49) months. Results In 13 cases, functional range of motion was obtained within 6 weeks of surgery. At final follow-up, 14 patients had a stable, pain-free elbow with a mean active range of motion of 13° to 140°. The average score on the Mayo elbow performance score was 98. Interpretation The use of the hinged fixator allows early motion of the elbow while preserving joint stability. It may have additional value in complex articular fractures when stable internal fixation cannot be obtained with ORIF, and in the presence of severe ligamentous injuries. Informa Healthcare 2010-04 2010-04-06 /pmc/articles/PMC2895343/ /pubmed/20180722 http://dx.doi.org/10.3109/17453671003685475 Text en Copyright: © Nordic Orthopedic Federation http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Research Article
Giannicola, Giuseppe
Sacchetti, Federico M
Greco, Alessandro
Gregori, Giuseppe
Postacchini, Franco
Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months
title Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months
title_full Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months
title_fullStr Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months
title_full_unstemmed Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months
title_short Open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: A retrospective study of 15 patients followed for 29 months
title_sort open reduction and internal fixation combined with hinged elbow fixator in capitellum and trochlea fractures: a retrospective study of 15 patients followed for 29 months
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895343/
https://www.ncbi.nlm.nih.gov/pubmed/20180722
http://dx.doi.org/10.3109/17453671003685475
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