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.