Our Summary

This paper describes a surgical procedure that uses an external device to stabilize or allow movement in the elbow after an injury or surgery. This device, called an external fixator, is especially useful in managing complex elbow injuries that involve the bones and ligaments, or if the elbow joint has a tendency to dislocate. It can also be used to slowly increase the range of motion in stiff elbows, or as a ’last resort’ treatment for older patients with other health issues.

There are some situations where this procedure isn’t recommended. Doctors need to be experienced in this specific operation, and the patient’s skin at the location of the surgery should be free of infection. It’s also important that the patient understands the procedure and is willing to follow their recovery plan.

The surgery involves making careful incisions and securing the fixator to the bone. The surgeon needs to have a good understanding of the location of nerves and blood vessels, and how to find the best position for the hinge in the device.

After surgery, the recovery plan will depend on the nature of the elbow injury. If the fixator is meant to allow movement, the goal is to get the patient moving their elbow as soon as possible. However, it might be necessary to temporarily lock the device. Caring for the area where the fixator is attached to the bone is crucial to prevent complications.

Research shows that this procedure can lead to good results in terms of elbow function, especially if the fixator is used to allow movement. However, there is a higher risk of complications compared to other surgeries. In a small sample of older patients with other health issues, the procedure was found to be satisfactory.

FAQs

  1. What is an external fixator and when is it used in elbow surgery?
  2. What factors determine if a patient is a suitable candidate for a surgical procedure involving an external fixator?
  3. What is the recovery process like after having surgery that involves an external fixator?

Doctor’s Tip

Overall, it’s important for patients to follow their doctor’s instructions closely during the recovery process. This may include physical therapy, pain management, and keeping the area clean to prevent infection. It’s also important to attend all follow-up appointments to monitor progress and address any concerns. With proper care and adherence to the recovery plan, patients can expect a successful outcome from elbow surgery with an external fixator.

Suitable For

Overall, patients who are recommended for elbow surgery using an external fixator are those with complex elbow injuries involving bones and ligaments, elbow joint instability, stiff elbows, or older patients with other health issues as a last resort treatment option. It is important for patients to have healthy skin at the surgical site, understand the procedure, and be willing to follow their recovery plan. The procedure requires a skilled surgeon who is experienced in using external fixators and has a good understanding of the anatomy of the elbow. Following surgery, the recovery plan will depend on the specific injury and may involve gradually increasing elbow movement. While the procedure can lead to good results in terms of elbow function, there is a higher risk of complications compared to other surgeries.

Timeline

Overall, the timeline of a patient’s experience before and after elbow surgery with an external fixator can be summarized as follows:

Before surgery:

  • Patient consultation with a specialist to determine if the procedure is appropriate
  • Preoperative assessments and tests to ensure the patient is a suitable candidate for surgery
  • Education on the procedure, expectations, and postoperative care

During surgery:

  • Incisions and placement of the external fixator on the elbow joint
  • Careful attention to nerve and blood vessel locations
  • Securing the fixator to the bone

After surgery:

  • Immediate postoperative care to monitor for any complications
  • Gradual progression of elbow movement if the fixator is meant to allow movement
  • Potential temporary locking of the fixator
  • Careful wound care to prevent infections
  • Rehabilitation and physical therapy to regain elbow function
  • Long-term follow-up appointments to monitor progress and address any issues that may arise

It is important for patients to follow their surgeon’s instructions closely and actively participate in their recovery to achieve the best possible outcome after elbow surgery with an external fixator.

What to Ask Your Doctor

Some questions a patient should ask their doctor about elbow surgery using an external fixator include:

  1. What specific injury or condition do I have that requires this type of surgery?
  2. How experienced are you in performing this specific procedure?
  3. What are the potential risks and complications associated with using an external fixator for elbow surgery?
  4. How long will I need to wear the external fixator, and what is the expected recovery time?
  5. Will I need physical therapy or rehabilitation after the surgery, and if so, what will that involve?
  6. What are the expected outcomes in terms of elbow function and pain relief?
  7. Are there any restrictions or limitations I should be aware of during the recovery process?
  8. What can I do to help prevent infection at the site of the surgery and care for the area where the fixator is attached to the bone?
  9. Are there any alternative treatment options available for my condition?
  10. What is the likelihood of needing additional surgeries or treatments in the future after having this procedure done?

Reference

Authors: Leschinger T, Ott N, Hackl M, Wegmann K, Müller LP. Journal: Oper Orthop Traumatol. 2020 Oct;32(5):387-395. doi: 10.1007/s00064-020-00676-6. Epub 2020 Sep 21. PMID: 32959082