Treatment of post-infection nonunion of the supracondylar humerus with Ilizarov external fixator.

BACKGROUND

Nonunion of the supracondylar area of the humerus is a very difficult area to treat. The Ilizarov method has been shown to be effective in the treatment of nonunion of the humeral diaphysis. However, there is little in the literature regarding the treatment of nonunion of the supracondylar area especially in post-infection cases.

METHODS

Eight patients with a mean age of 45.73 ± 11.42 years were treated for post-infection nonunion of the supracondylar area of the humerus with the Ilizarov method and followed up for 3 years. All had undergone at least 2 previous failed operations. The patients were evaluated radiologically and clinically with an outcome survey using the Disabilities of the Arm, Shoulder and Hand (DASH) score.

RESULTS

Solid union was achieved in all patients in a mean time of 6.87 ± 0.99 months. All patients had improvement in shoulder and elbow motion after treatment. The mean DASH score before surgery was 90.66 ± 5.66, whereas that after surgery was 24.62 ± 3.85. There was a significant improvement in the DASH score after surgery; the mean difference was 66.04 ± 1.81, with a t value of 35.88 (P < .001). All patients were satisfied with the treatment and returned to a more normal lifestyle with no pain, as well as complete soft-tissue recovery. None had recurrence of infection.

CONCLUSION

Ilizarov treatment for post-infection nonunion of the supracondylar humerus was shown to be effective, reliable, and tolerated by the patients.