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Hinged elbow fixator: An extracorporeal technique to position the hinge based on an original guidewire device

Abstract : 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.
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Contributor : Olivier Bartier <>
Submitted on : Thursday, May 28, 2015 - 9:59:51 AM
Last modification on : Wednesday, January 13, 2021 - 3:13:48 AM



Marc Begin, Laura Ruscio, Louis Ratte, Olivier Bartier, Olivier Gagey, et al.. Hinged elbow fixator: An extracorporeal technique to position the hinge based on an original guidewire device. Chirurgie de la Main, Elsevier Masson, 2013, 32, pp.210-218. ⟨10.1016/j.main.2013.04.008⟩. ⟨hal-01157508⟩



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