The use of articulated external fixation for complex elbow trauma treatment

  • A. Pizzoli
  • M. BondiEmail author
  • L. Schirru
  • R. Bortolazzi
Original Article



We use external elbow joint fixator (FE-F4) for fracture and dislocation of the ulnohumeral joint to evaluate the early articular mobilization maintaining concentric reduction, protecting the osteoligamentous reconstruction and avoiding postoperative stiffness.

Materials and methods

Thirty-two patients (13 men and 19 women) were treated with FE-F4: 7 simple dislocations (21.9%), 15 distal humerus fractures (46.9%), 4 fractures and dislocations of which 1 terrible triad (12.5%), and 6 complex dislocations (18.7%). The mean age was 64 years. The average follow-up (FU) was 47 months. We evaluated the flexion–extension and prone-supination movement arc, VAS (Visual Analogue Scale), Quick DASH (Disability of the Arm, Shoulder and Hand score), MEPI (Mayo Elbow Performance Index) and the Broberg and Morrey rating system.


The average ROM was 125.9° for flexion–extension, 77.8° for pronation and 79.7° for supination. The average VAS was 0.56 at the FU, the MEPI score of 93.6, the Broberg and Morrey rating system of 92.4 and the Quick DASH of 8.7. No major complications were found after surgery, and no objective or subjective posterolateral or medial joint instability was found. No patients at the FU had a new surgery with arthromyolysis or elbow arthroplasty.


The elbow joint stiffness is the main cause of functional inability for the patient suffering from posttraumatic outcomes. The FE-F4 allows an early mobilization, even in case of injuries or complex reconstructions, keeping the joint stable and protecting any bone synthesis and the damaged capsule-ligament structures.

Levels of evidence



Articulated external fixation Elbow fracture Elbow instability Humerus fracture 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Everything was approved by the corporate ethics committee.

Informed consent

The study concerns human patients who have signed an informed consent allowing data collection


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Copyright information

© Istituto Ortopedico Rizzoli 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic and TraumatologyASST – Mantova Carlo PomaMantuaItaly

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