RT Journal
A1 Baumann, Gregor
A1 Nagy, Ladislav
A1 Jost, Bernhard
T1 Radial Nerve Disruption Following Application of a Hinged Elbow External FixatorA Report of Three Cases
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD May 18
VO 93
IS 10
SP e51 1
OP 4
DO 10.2106/JBJS.J.00436
UL http://dx.doi.org/10.2106/JBJS.J.00436
AB 
A hinged or articulated elbow external fixator is recommended for patients with elbow instability1, as a protective device following extensive capsular release of elbow contractures2, after ligamentous reconstruction3, for distraction interposition arthroplasty4, and in the management of complex elbow fracture-dislocations5. 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 elbow6, 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 literature1,7, to the best of our knowledge no permanent radial nerve palsy has been documented following application of a hinged external fixator. We present three cases of radial nerve palsy due to complete nerve disruption after application of a hinged external fixator for the treatment of complex elbow injuries.