Salvage of non-union of supracondylar fracture of the humerus by total elbow arthroplasty.
Fourteen patients in whom open reduction and internal fixation could not be achieved satisfactorily had a total elbow arthroplasty for non-union of a supracondylar humeral fracture. All patients had an established non-union, and ten had had from one to four previous attempts at internal fixation. The average age at the time of operation was sixty-five years. The average duration of follow-up was five years, with a minimum of two years. The average preoperative elbow score was 17 points, with both pain and functional disability present. The average postoperative score was 84 points; there were eight good or excellent results and three failures. The latter three patients had an additional operation: one each for dislocation, loosening of the humeral component, and deep infection. Salvage of supracondylar non-union by means of a total elbow arthroplasty is a technically demanding procedure. Strict indications for selection of patients must be followed. A semiconstrained implant is recommended, with preservation of the epicondyles and their muscular attachments in order to achieve balance of the soft tissues.
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Hospital for Special Surgery, Cornell University Medical School, New York City.
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D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000503:physiopathology / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D014945:Wound Healing