Primary Hinged External Fixator for Complex Fracture Dislocations of the Elbow: Systematic Review and Meta-Analysis

Abstract

High-energy traumatic injuries affecting the elbow joint have been increasing due to the more frequent practice of extreme sports. Complex elbow dislocation might cause severe impairments, affecting both sports practice performance and activities of daily living. An accurate diagnosis is the key step to a correct strategy and a clear algorithm aiming at the best therapeutic approach. Several technical options have been developed in recent years, which must be considered and thus require continuous study and update. Surgical treatment is hardly the end of the story and the functional recovery of the elbow joint after such injuries often dictates the need for a demanding rehabilitation protocol. Hinged external fixation can be a useful tool in the complex fracture dislocation of the elbow. It should be applied in expert centers with a team approach of both operative applications, monitoring of complications, and structured aftercare. Indications of the hinged external fixation in traumatic elbow disorders include a wide variety of injuries ranging from instability after simple dislocation to complex fracture–dislocations.