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Elbow External Fixation 20690

elbow cross sectional anatomy

synonyms:elbow external fixation, elbow ex fix, elbow spanning ex fix

Elbow External Fixation CPT

Elbow Ex Fix Indications

  • Elbow Dislocation
  • Distraction Interposition Arthroplasty (Morrey BF, CORR 1993:293:46) (Chen SL, JBJS 2000;82B:233)

Elbow Ex Fix Technique

  • key is recreation of the axis of rotation
  • axis is within the distal aspect of the humerus
  • attach frame to humerus first.
  • the center of rotation from the medial view is slightly distal and anterior to the medial epicondyle.  From the lateral view the center of rotation is in the center of the capitellum (ICL 82A:733, 2000)
  • most systems have detailed instructions for locating the axis.

Elbow Ex Fix Complications

  • Pin-tract infection
  • Deep infection (osteomyelitis)
  • Loss of reduction
  • Ulnar nerve palsy
  • Posterior interosseous nerve palsy (Tomaino MM, J Hand Surg [Am] 1999;24:554)
  • Fracture
  • Reflex Sympathetic Dystrophy

Elbow Ex Fix Outcomes

  • (Yu JR, JSES 2007;16:60)

Elbow Ex Fix References

  • Tan V, JAAOS 2005;13:503
  • Deland JT, Garg A, Walker PS: Biomechanical basis for elbow hinge-distractor design. Clin Orthop Relat Res 1987;:303-312.
  • London JT: Kinematics of the elbow. J Bone Joint Surg Am 1981;63:529-535.
  • Morrey BF: Distraction arthroplasty: Clinical applications. Clin Orthop Relat Res 1993;:46-54.
  • Madey SM, Bottlang M, Steyers CM, Marsh JL, Brown TD: Hinged external fixation of the elbow: Optimal axis alignment to minimize motion resistance. J Orthop Trauma 2000;14:41-47.
  • Morrey BF: Post-traumatic contracture of the elbow: Operative treatment, including distraction arthroplasty. J Bone Joint Surg Am 1990;72:601-618.
  • McKee MD, Bowden SH, King GJ, : Management of recurrent, complex instability of the elbow with a hinged external fixator. J Bone Joint Surg Br 1998;80:1031-1036
  • Cobb TK, Morrey BF: Use of distraction arthroplasty in unstable fracture dislocations of the elbow. Clin Orthop Relat Res 1995;:201-210.
  • O’Driscoll SW, Jupiter JB, King GJ, Hotchkiss RN, Morrey BF: The unstable elbow. Instr Course Lect 2001;50:89-102.
  • Jupiter JB, Ring D: Treatment of unreduced elbow dislocations with hinged external fixation. J Bone Joint Surg Am 2002;84:1630-1635.
  • Cheng SL, Morrey BF: Treatment of the mobile, painful arthritic elbow by distraction interposition arthroplasty. J Bone Joint Surg Br 2000;82:233-238
  • Ring D, Jupiter JB: Operative release of complete ankylosis of the elbow due to heterotopic bone in patients without severe injury of the central nervous system. J Bone Joint Surg Am 2003;85:849-857.