Keywords : compound comminuted fractures around elbow

Management of Compound Comminuted Fractures in and Around Elbow Joint Using Across Elbow External Fixation Followed By Eearly Active Movement

Ali Bakir Al-Hilli

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 3, Pages 201-208

Compound comminuted fractures around elbow are one of the most common injuries in our country today due to high velocity missile injuries they present a great challenge to the orthopaedic surgeon and severe suffering to the patients as comminution makes anatomical reduction impossible and stiffness is a well known associate .This study was designed to evaluate the functional outcome for such injuries.
To evaluate the functional results of management of compound fractures in and around elbow joint using across elbow external fixation and early physiotherapy.
A case series study was designed, a (20) patients presented to the orthopaedic and trauma department in the Medical City / Surgical Specialties teaching Hospital / Baghdad/ during the last two years 2006-2007 , with history of high velocity missile injury to their elbow or around it, all of them treated by early wound excision and application of across elbow external fixation followed up for 6 weeks till healing of their wounds then the external fixation was removed and active assisted movement were started, patients followed up for 6 months and assessed both clinically and radiographically.
Good range of elbow movement and return to the original work of the patients were noted in 100% of the patients, and follow up for the first 6 weeks after removal of the external fixation shows that most of the patients (15) got functional range of elbow movement, According to Mayo elbow performance score nine patient got 95 points and eleven got 85 points.
Functional range of elbow movement can be achieved in compound comminuted fractures in and around elbow by using external fixation across the joint then physiotherapy.