Combined use of Kirschner wires and hinged external fixator for capitellar and trochlear fractures: a minimum 24‐month follow‐up

• Published in: ANZ journal of surgery 2019-03, Vol.89 (3), p.196-200
• Main Authors: He, Shu‐Kun, Zhao, Si‐Chun, Guo, Jin‐Hai, Qin, Ting‐Wu, Huang, Fu‐Guo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bone healing; Bone implants; Bone Wires; Comparative studies; Computed tomography; Elbow; Elbow (anatomy); elbow joint; Elbow Joint - injuries; Elbow Joint - physiology; Elbow Joint - surgery; Equipment Design; external fixator; External Fixators; Female; Fixation; Follow-Up Studies; fracture fixation; Fractures; Humans; Humeral Fractures - surgery; Image classification; Kirschner wire; Male; Middle Aged; Patients; Radiographs; Radiography; Range of Motion, Articular; Recovery of function; Rehabilitation; Retrospective Studies; Rods; Sutures; Time Factors; trauma; Young Adult
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.14924

Background Open reduction and internal fixation is the adequate treatment for capitellar and trochlear fractures. Given the low incidence of this type of fractures, it is difficult to constitute a universally accepted method for fixation. Thus, we hypothesised that combined use of Kirschner wires (K‐wires), absorbable rods and sutures for fixation and post‐operative hinged external fixator for early rehabilitation exercise can restore elbow joint function well. Methods This retrospective study included 20 patients with a mean age of 48.3 (range 16–76) years. According to the Dubberley classification, fractures were classified on plain radiographs, computed tomography images and intra‐operative findings. All patients were evaluated by the range of motion of the elbow and the Broberg‐Morrey score. Results All fractures had healed without non‐union, and the average time was 13.6 (range 8–17) weeks. The mean follow‐up was 42.5 (range 24–80) months. The mean flexion was 117.1° (range 90°–135°), and the mean extension was 17.5° (range 0°–45°). The mean pronation was 74.4° (range 45°–85°), and the mean supination was 84.3° (range 60°–90°). The average Broberg–Morrey score was 86.2 (range 68–98) points with 10 excellent, 7 good and 3 fair results. Conclusion K‐wires, absorbable rods and sutures combined with hinged external fixator are feasible for fixation of capitellar and trochlear fractures. However, due to the absence of a control group (such as Herbert screw fixation), comparative studies are still needed to demonstrate the safety and reliability of K‐wires for fixation.