Internal Joint Stabilizer: A Safe Treatment for Traumatic Elbow Instability

Objectives: To report early results of the “Internal Joint Stabilizer of the Elbow” (IJS-E) in the treatment of terrible triad injuries and other unstable traumatic elbow dislocations. Design: Retrospective cohort study. Setting: Level 1 trauma center. Patients/Participants: Seventeen patients with traumatic elbow instability treated with IJS-E over a 2-year period; 7 of whom sustained terrible triad-type injuries. Interventions: Open reduction internal fixation with the “IJS-E”. Main Outcome Measures: Elbow stability and arc of motion were assessed radiographically and clinically. Disabilities of the Arm, Shoulder and Hand scores were collected by telephone. Results: All elbows were radiographically stable at the time of IJS-E removal. Mean time of follow-up was 9 months from index operation (range, 2.5–24 months). Mean elbow arc of motion was restored to flexion-extension 92 degrees (range, 5–125; SD, 31 degrees) and forearm pronation-supination 139 degrees (range, 0–180; SD, 48 degrees). Mean Disabilities of the Arm, Shoulder and Hand score was 22.2 (range, 7.5–45.7; SD, 13.3) for patients at least 1 month from surgery on the ipsilateral extremity. Five patients (30%) developed complications, and —2 (12%) required revision for implant failure. Conclusions: The IJS-E offered reliable treatment of traumatic elbow instability, particularly terrible triad-type injuries. It permited early range of motion and was effective in restoring elbow stability. We believe that the use of this relatively novel system should be further explored. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.