Neurovascular complications in hinged external fixator of the elbow

Abstract

Background: The use of a hinged external fixator on elbow is an effective procedure. Several international publications reported the results of the treatment after using the fixator. However. there was no reported study focusing on the neurovascular complications. Objective: To report the result of hinged external fixator surgery in patients with instable elbow conditions focusing on the neurovascular complications. Materials and Methods: A retrospective review of patients with applied hinged external fixator of the elbow between April 2011 and May 2017 at HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University in Nakhon Nayok Province was performed. The data of complications were collected from the surgery until 16 weeks after the procedure. Results: Thirteen patients of traumatic elbow had hinged external fixator applied. The authors found that neurovascular complications occurred in four cases (30.8%). One case developed a major neurovascular complication, which was permanent radial nerve damage (7.7%). The other three cases developed minor neurovascular complications, which was transient radial nerve injuries in two patients and transient ulnar nerve injury in one patient (23.1%). One case developed ulnar fracture associated with hinged external fixator (7.7%). Conclusion: Hinged external fixator of the elbow is considered an effective device. However, high complication rates have been detected. Therefore, orthopedic surgeons should be aware of the complications, especially the radial and ulnar nerve injury. © Journal of the Medical Association of Thailand.