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Article Dans Une Revue Chirurgie de la Main Année : 2013

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

Marc Begin
  • Fonction : Auteur
Laura Ruscio
  • Fonction : Auteur
Louis Ratte
  • Fonction : Auteur
Olivier Gagey
  • Fonction : Auteur
Marc Soubeyrand
  • Fonction : Auteur

Résumé

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.

Dates et versions

hal-01157508 , version 1 (28-05-2015)

Identifiants

Citer

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, 2013, 32, pp.210-218. ⟨10.1016/j.main.2013.04.008⟩. ⟨hal-01157508⟩
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