Arthroscopic Reduction and Internal Fixation of Elbow Fractures

Arthroscopic reduction and internal fixation (ARIF) procedures in elbow surgery have evolved over the last 15 years. In specific types of radial head, capitellum, and coronoid fractures, arthroscopy presents several advantages including improved visualization of the fracture fragments, better wound healing, and almost complete soft-tissue preservation. Direct arthroscopic evaluation of the severity of instability is possible and stable fixation of the fractures can be performed. Additional procedures such as excision of comminuted fragments or posterolateral plication in case of ligamentous deficiency can be effectively performed. Although specific skills in elbow arthroscopy are required and possible risks and complications have been described, the indications are steadily being defined, and surgical techniques and outcomes are improving. A preoperative CT scan is recommended and in case of difficulties or doubts, a low threshold to convert the ARIF technique in open surgery is suggested.