Hinged External Fixation in Acute Elbow Trauma

Complex fracture dislocations of the elbow present a challenge for the upper extremity surgeon. The extent of the osseous and soft tissue injuries determines the stability of the elbow joint. Post-traumatic elbow stiffness is a debilitating complication which poses a major threat to the integrated function of the entire limb. Thus, restoration of motion is the fundamental basic of most reconstructive efforts following traumatic injury to the elbow. More recently, hinged external fixation has become an important tool in both the acute treatment of severe fracture dislocation and post-traumatic reconstruction of the elbow. Its use has expanded from a “last hope effort” to earlier utilization in a standardized protocol, the so- called elbow fixator concept. In this chapter we will describe the philosophy, the operative technique, and the tips and tricks of performing hinged fixation in acute elbow trauma.