Elbow fracture-dislocation is always demanding\nto manage due to the considerable soft-tissue swelling\nor damage involved, which can make an early open\napproach and ligamentous reconstruction impossible. The\npurpose of this study was to evaluate the role of elbow\nhinged external fixation (HEF) as a definitive treatment in\npatients with elbow dislocations associated with Reganââ?¬â??\nMorrey (R-M) type I and II coronoid fractures and softtissue\ndamage. We treated 11 patients between 2010 and\n2012 with HEF. Instability tests and standard X-ray\nexaminations were performed before surgery and 1ââ?¬â??3 to\n3ââ?¬â??6 months after surgery, respectively. All patients\nunderwent a preoperative CT scan. Outcomes were assessed\nwith a functional assessment scale (Mayo Elbow Performance\nScore, MEPS) that included 4 parameters: pain,\nROM, stability, and function. The results were good or\nexcellent in all 11 patients, and no patient complained of\nresidual instability. Radiographic examination showed\nbone metaplasia involving the anterior and medial sides of\nthe joint in 5 patients. HEF presented several advantages: it\nimproves elbow stability and it avoids long and demanding\nsurgery in particular in cases with large soft tissue damage.\nWe therefore consider elbow HEF to be a viable option for\ntreating R-M type I and II fracture-dislocations.
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