A hinged external fixator for complex elbow dislocations: A multicenter prospective cohort study

The design of the study will be a multicenter prospective cohort study of 30 patients who have sustained a complex elbow dislocation and are treated with a hinged elbow fixator following fracture fixation because of residual instability. Early active motion exercises within the limits of pain will be started immediately after surgery under supervision of a physical therapist. Outcome will be evaluated at regular intervals over the subsequent 12 months. The primary outcome is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford Elbow Score, pain level at both sides, range of motion of the elbow joint at both sides, radiographic healing of the fractures and formation of periarticular ossifications, rate of secondary interventions and complications, and health-related quality of life (Short-Form 36).The outcome of this study will yield quantitative data on the functional outcome in patients with a complex elbow dislocation and who are treated with ORIF and additional stabilization with a hinged elbow fixator.The trial is registered at the Netherlands Trial Register (NTR1996).The elbow joint is the second most commonly dislocated joint in adults. The annual incidence of elbow dislocations in children and adults is 6.1 per 100,000 [1]. Elbow dislocations are classified as being simple or complex [2]. Simple dislocations are dislocations without fractures. Complex dislocations are associated with fractures of the radial head, olecranon, or coronoid process. In patients with an elbow dislocation the incidence of radial head fractures is 36%, whereas coronoid process fractures occur in 13%, and olecranon fractures in four percent of patients [1].The radial head and coronoid process are considered to be important bony stabilizers of the elbow. The fundamental goal in the management of complex elbow dislocations is the restoration of the osseous-articular restraints. Therefore, the majority of