Radial Nerve Disruption Following Application of a Hinged Elbow External Fixator: A Report of Three Cases

Gregor Baumann; Ladislav Nagy; Bernhard Jost

doi:10.2106/JBJS.J.00436

$<h2>Introduction</h2> A hinged or articulated elbow external fixator is recommended for patients with elbow instability 1 , as a protective device following extensive capsular release of elbow contractures 2 , after ligamentous reconstruction 3 , for distraction interposition arthroplasty 4 , and in the management of complex elbow fracture-dislocations 5 . The hinged external fixator permits early postoperative elbow mobilization while maintaining elbow stability. There is a growing recognition of the value of and indications for articulated external fixation of the elbow 6 , despite the possibility of serious complications. Cheung et al. 6 classified complications related to hinged external fixators of the elbow as major and minor. Minor complications, which occurred in 15% of patients, included local erythema and nonpurulent pin-site drainage lasting longer than five days and the need for skin release to decrease tension adjacent to the pins. Major complications, which occurred in 10% of patients, included purulent pin-site drainage, fixator malalignment, pin loosening, and deep infection. Although cases of transient radial nerve palsy are described in the literature 1 , 7 , to the best of our knowledge no permanent radial nerve palsy has been documented following application of a hinged external fixator. We$

Radial Nerve Disruption Following Application of a Hinged Elbow External Fixator: A Report of Three Cases

Baumann, Gregor; Nagy, Ladislav; Jost, Bernhard

Follow Journal of Bone and Joint Surgery , Volume 93 (10): e51 JB&JS – May 18, 2011