Article

The application of a hinged elbow external fixator is technically
demanding because the hinge axis must coincide exactly with the flexion-extension
axis of the elbow. The standard technique involves inserting a 3-mm K-wire
freehand into the distal humerus to materialize the flexion-extension axis. We
designed a guidewire device for extracorporeal hinge positioning without K-wire
insertion. In a cadaver study, we compared freehand K-wire insertion and our
extracorporeal technique. METHODS: In 12 cadaveric elbows, we induced acute elbow
instability by sectioning the medial collateral ligament complex and the anterior
and posterior capsule. A hinged external fixator was applied to each elbow using
both techniques. The outcome measures were procedure duration, number of
image-intensifier shots (as a measure of radiation exposure), and passive motion
range after fixator implantation. RESULTS: Compared with the freehand K-wire
technique, the extracorporeal technique provided greater range of motion and
significantly lower values for procedure duration and number of image-intensifier
shots. Data dispersion was less marked with the extracorporeal technique,
indicating better reproducibility. CONCLUSION: The extracorporeal technique based
on a guidewire device enabled non-invasive positioning of a hinged elbow external
fixator. This technique was faster, less irradiating, and more reproducible than
the freehand K-wire technique.
CI - Copyright (c) 2013 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS