Hinged elbow fixator: An extracorporeal technique to position thehinge based on an original guidewire device

International audienceThe application of a hinged elbow external fixator is technically demanding because the hinge axis must coincide exactly with theflexion–extension axis of the elbow. The standard technique involves inserting a 3-mm K-wire freehand into the distal humerus to materialize theflexion–extension axis. We designed a guidewire device for extracorporeal hinge positioning without K-wire insertion. In a cadaver study, wecompared freehand K-wire insertion and our extracorporeal technique.Methods. – In 12 cadaveric elbows, we induced acute elbow instability by sectioning the medial collateral ligament complex and the anterior andposterior capsule. A hinged external fixator was applied to each elbow using both techniques. The outcome measures were procedure duration,number of image-intensifier shots (as a measure of radiation exposure), and passive motion range after fixator implantation.Results. – Compared with the freehand K-wire technique, the extracorporeal technique provided greater range of motion and significantly lowervalues for procedure duration and number of image-intensifier shots. Data dispersion was less marked with the extracorporeal technique, indicatingbetter reproducibility.Conclusion. – The extracorporeal technique based on a guidewire device enabled non-invasive positioning of a hinged elbow external fixator. Thistechnique was faster, less irradiating, and more reproducible than the freehand K-wire technique