The elbow fragment external fixator is suitable for the small fragment External Fixation and protection of the elbow joint in patients with elbow injury, dislocation and surgery.
Its main indications include fractures around the elbow (internal and external hip region of the humerus, olecranon of the ulna, head of the radius), such fractures or dislocations with ligamentous instability, open fractures of the elbow, posttraumatic elbow stiffness, and severe comminuted intra-articular fractures.
Parts
Reference NO.: L008 4pcs bone screws of φ5*110mm were used for the elbow joint frame.The main matching instruments were a 3mm hex wrench and a φ5.0mm screw driver.The Elbow Joint Fixator was generally fixed to the lateral side of the elbow joint, the first screw of the proximal humerus was fixed to the deltoid insertion, and the forearm screw was generally fixed to the middle part of the ulna.
Surgical orthopedic fixation procedures
1. A 2.0mm diameter Kirschner wire was inserted into the center of the humeral trochlea with a depth of 2-3cm. Under enhanced imaging monitoring, the Kirschner wire was examined in the anteroposterior and lateral view. Note: In the case of comminuted fractures, passage of the proximal cortical bone alone is sufficient to avoid injury to the ulnar nerve.
2. Slip the external fixator through the Kirschner wire and adjust the position of the ring chain so as to leave enough space for the subsequent reduction. At this time, the locking screw of the ring chain is temporarily tightened.
3. The skin was cut at the insertion site of the humeral nail clip, and the lateral surface of the humerus was exposed by blunt separation to avoid injury to the radial nerve. The most proximal screw was first inserted at the distal end of the deltoid muscle. Cortical bone screws of 6/5mm diameter were inserted after pre-drilling with a 4.8mm drill bit.
4. Insert a second humeral screw in the same way, at the hole of the fourth screw in the nail clip. Note: A smaller thread diameter of 4.5/3.5mm is selected for small humerus with diameter less than 20mm.
5. Ulnar screw insertion: in the neutral position of the forearm, a screw is inserted into the dorsal side of the ulna, and the screw is placed as far as possible along the midline of the longitudinal axis of the diaphase to avoid damage to the bone strength. After drilling with a 3.2mm drill, the distal screw is inserted first. The screw must pass through the contralateral cortex.
6. Insert a second ulna screw as described above, at the 4th hole of the screw clip, and check the arrangement of the external bracket by viewing it in the anteroposterior view.
7. Lock the triangle knob and tighten the locking bolts of each chain. Tighten the ball joint with a wrench.
8. When the triangle knob was relaxed, the elbow flexion and extension were observed by the X-ray image enhancement system to confirm that the external bracket was arranged correctly and the joint activity was symmetrical. Finally, the ball wrench was used to lock it.
9. Remove the 2mm Kirschner wire by locking the outer bracket at an appropriate Angle (recommended to 700 flexion in full extension) with the triangular knob of the central connection unit.
10. According to the needs of the situation, add a certain internal fixation, the first choice of bone chip nail system.
In conclusion, the advantages of using elbow brace for external fixation are mainly super-articular fixation, early joint mobility, and forearm rotation is not affected.
