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The Journal of Bone and Joint Surgery, Vol 71, Issue 7 1058-1065, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Salvage of non-union of supracondylar fracture of the humerus by total elbow arthroplasty
MP Figgie, AE Inglis, CS Mow and HE Figgie
Hospital for Special Surgery, Cornell University Medical School, New York City.
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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