Internal Joint Stabilizer: A Safe Treatment for Traumatic Elbow Instability

Abstract

Objectives: To report early results of the "Internal Joint Stabilizer of the Elbow" (IJS-E) in the treatment of terrible triad injuries and other unstable traumatic elbow dislocations.

The Internal Joint Stabilizer of the Elbow: A Systematic Review of the Clinical and Biomechanical Evidence

“…A total of nine retrospective reports on the IJS with a sample of 171 cases and a mean follow-up of 10.8 months were included ( Table 1 ). 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 The mean MCMS was 61 (range: 56–67), which indicates a moderate quality of reporting across all groups. Indications are detailed in Table 2 , and device-related complications are demonstrated in Table 3 .…”

“…The most common injury pattern for which the IJS was indicated was acute presentation of a terrible triad (53%). Across seven articles, the mean Disabilities of the Arm, Shoulder, and Hand score was 22.4 (range: 11.7–37), 10 , 11 , 12 , 13 , 14 , 15 , 17 and across four articles, the mean Mayo Elbow Performance Score (MEPS) was 82 (range: 74–94). 13 , 14 , 15 , 17 All nine articles reported the elbow flexion extension arc for a mean of 111°.…”

Acute operative stabilization of an elbow dislocation and associated brachial artery injury: a case report

“…15 Use of an internal joint stabilization system could be considered given good outcomes in the literature for treatment of traumatic elbow instability; however this would also have necessitated a second surgery for implant removal. 16 We ultimately elected to perform acute soft tissue repair. The patient's distal upper extremity was partially perfused through collateral blood flow limiting concerns about tissue ischemia and necrosis.…”

“…Another alternative would have been cross-pinning of the elbow joint, but like an external fixator this would have required a second procedure for delayed pin removal 15. Use of an internal joint stabilization system could be considered given good outcomes in the literature for treatment of traumatic elbow instability; however this would also have necessitated a second surgery for implant removal 16…”

Improved Understanding of Traumatic Complex Elbow Instability

“…The literature demonstrates low rates of recurrent subluxation with variable rates of complications across a spectrum of elbow instability cases. [45][46][47] In a multicenter report, 96% (23/24) cases maintained concentric reduction at 24 to 26 weeks after device removal. 47 The mean DASH score was 16, and 92% (22/24) patients scored excellent or good on the Broberg-Morrey Functional Score.…”