Abstract
Background: Complex elbow fracture-dislocations represent a substantial surgical challenge. Achieving adequate stability while permitting early postoperative motion is essential to prevent stiffness. The internal joint stabilizer (IJS) has emerged as an alternative to hinged external fixation, providing internal dynamic stabilization with improved patient tolerance and reduced risk of soft-tissue complications. Although the IJS is commonly inserted through a lateral approach, injuries involving multiple anatomical structures may necessitate broader exposure. Purpose: To describe the surgical technique for IJS insertion through a posterolateral approach (PLA) for complex elbow injuries involving multiple anatomical structures. Methods: The PLA provides extensile exposure to the posterior, lateral, and medial aspects of the elbow through a single incision. The approach uses the interval between the ulna and the anconeus muscle to assess the radiocapitellar and ulnohumeral joints. A structured sequence of reconstruction is followed. Coronoid fixation, radial head management, ligamentous reconstruction, and ulnar nerve decompression are performed before IJS assembly. Fluoroscopic guidance is used to ensure accurate placement of the central axis pin. Results: The PLA facilitates single-incision management of complex elbow instability. Proper sequencing improves visualization and implant positioning, avoids interference among fixation elements, and supports a concentric ulnohumeral reduction. Once assembled, the IJS maintains stable reduction and permits controlled range of motion. Conclusion: The PLA for IJS insertion is an effective technique for complex elbow injuries requiring access to multiple anatomical structures through a single incision. It facilitates efficient IJS placement, achieves stable fixation, and promotes early mobilization while minimizing complications associated with external fixation.
Recommended Citation
Pirela-Cruz, Miguel A.; Nikalus Skipp; Ana Love; Deana Mercer; and Jazzlyn Gonzalez. "Insertion of an Internal Joint Stabilizer Through a Posterolateral Approach for the Management of Complex Elbow Instability." Western Journal of Orthopaedics 15, 1 (2026). https://digitalrepository.unm.edu/wjo/vol15/iss1/11