Acute complex instability of the elbow treated with internal joint stabilizer IJS-E System

Abstract

IntroductionTreatment of acute complex fracture-dislocation of the elbow has been associated with a high rate of complications. Internal Joint Stabilizer of the Elbow (IJSE) device appears as a valid option to optimise and improve our results. Material and methodsWe present a retrospective case series of five patients treated at our institution with IJS-E System (Skeletal DynamicsR) from February 2019 to 2020. Our inclusion criteria was: patients over 18 years old surgically treated with IJS-E due to persistent elbow instability despite of a suitable osteoligamentous surgical repair. ResultsWe obtained a total of five patients (4 males and 1 female) with an average age of 37.4 years old (24–71). The Injury pattern was posterolateral instability, TTIE in all cases. The mean final postoperative MEP score was 94 points (85–100) and the postoperative DASH score was 11.78 points (4.2–20.6) with an average follow-up of 9.8 months (6–12). We described a final arc of motion of 134° with a range of flexion between 120° and 140° and a mean lack of extension of 12° (5°–20°), with a complete arc of pronosupination. As complications we found one case of heterotopic ossification and one case of elbow stiffness. However, no complications device-related or articular incongruence were reported during follow-up. ConclusionsThe IJS-E device appears as an effective alternative instead of external fixation. Nevertheless, a high rate of reoperation up to 100% is associated with IJS-E. A larger series, longer follow-up and prospective studies are needed to define properly his role in the surgical treatment of acute elbow instability.