Patient outcomes for the Internal Joint Stabilizer of the Elbow (IJS-E)

Abstract

Recently, the Internal Joint Stabilizer of the Elbow (IJS-E) was developed as an internal dynamic fixator for use in the setting of traumatic elbow instability. This study reviews the patients who had an IJS-E placed at our institution. Specifically, postoperative complications, postoperative functional outcomes, and need for subsequent procedures were reviewed. A retrospective chart review was conducted of patients in whom the IJS-E was implanted from June 2016 to July 2018. Indications for use, range of motion at final follow-up, and the need for subsequent procedures were reviewed. Disabilities of the Arm, Shoulder, and Hand (DASH) and Broberg-Morrey scores were also obtained. Ten IJS-E devices were implanted into 10 patients. Average length of follow-up was 13.4 months. Average flexion-extension and pronation-supination motion arcs at final follow-up were 106° and 141°, respectively. Seventy-eight percent of patients achieved >100° arcs of both flexion-extension and pronation-supination. Average DASH and Broberg-Morrey scores were 28.7 and 68.2, respectively. Four subsequent procedures were required in 4 patients: 2 contracture releases, 1 medial collateral ligament reconstruction, and 1 total elbow arthroplasty. There were no postoperative infections or nerve injuries. The IJS-E has replaced the use of external hinged fixation at our institution. Final range of motion was consistent with that reported for terrible triad and complex elbow dislocation injuries. The IJS-E is a good option for use in patients with traumatic elbow instability, as it restores motion and function without immediate postoperative complication. However, it does not eliminate the potential for future operative intervention in these complex injuries.