Internal Joint Stabilizer Versus Stand-alone Ligament Repair in Treatment of Traumatic Elbow Instability: An Age Matched Analysis

Scritto il 21/04/2025
da Mark P Smith

J Shoulder Elbow Surg. 2025 Apr 19:S1058-2746(25)00333-7. doi: 10.1016/j.jse.2025.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: Traumatic elbow instability is a complex problem, and treatment often involves addressing bony injury followed by ligament and capsular repair with or without external fixation. The Internal Joint Stabilizer (IJS) is a dynamic internal fixator that is an alternative treatment for addressing soft tissue injuries that has gained popularity among treating surgeons. The purpose of this study is to compare the outcome of an IJS with conventional primary repair approaches in the treatment of traumatic elbow instability.

METHODS: Patient demographics, injury characteristics, surgical findings, and postoperative results were obtained retrospectively from three trauma centers using Current Procedural Terminology (CPT) codes from the electronic medical record. Patients were then matched by age, and the group of patients who were treated with the IJS were compared to those who did not. Range of motion (ROM) at the elbow and wrist, and data regarding secondary surgeries was gathered longitudinally for 6 months postoperatively.

RESULTS: A total of 106 patients met the inclusion criteria, 27 of which had an IJS implanted. After matching, 26 patients from each treatment group were included in the study. There were no statistically significant differences in flexion, extension, supination, pronation, supination-pronation arc, and flexion-extension arc (all p>0.05). The IJS group had a higher rate of reoperation (p=0.03).

CONCLUSION: Patients who underwent placement of the IJS had equivalent elbow and wrist range of motion at 6 months with a higher reoperation rate compared to the non-IJS cohort.

LEVEL OF EVIDENCE: Level III; Retrospective Cohort Comparison; Treatment Study.

PMID:40258530 | DOI:10.1016/j.jse.2025.03.012