Treatment of humerus supracondylar nonunion with pin and plate fixation as a simple device

Abstract

Introduction

Pin and plate fixation as an effective internal fixation for humerus supracondylar fracture has been introduced. It is especially useful in difficult cases with comminuted fractures or very low fracture line. We used this technique for treatment of difficult cases of humerus supracondylar nonunions and reviewed its results.

Material and methods

From October 2008 to September 2014, 27 patients with humerus supracondylar nonunion underwent open reduction and internal fixation with pin and plate in one or both column with or without bone grafting. Results and complications were evaluated.

Surgical technique of pin and plate

After preliminary reduction two or more 1.2 mm pin inserted cross nonunion site like a preliminary fixation. Pins were bent to be placed on the humeral posterior cortex, a 3.5 mm three or four holes reconstruction plate put on the pins and was fixed to humerus with two screws. In the cases with very small distal segment as an alternative, the pins inserted parallel to articular surface and were bent at both side and be placed on humerus as a delta frame and were fixed with a plate on them.

Results

In 6 years we had 27 patients with supracondylar humerus nonunion that pin and plate fixation was used as fixation device for one column in 12 of them and for both column in 15 of them. Age of the patients was 19 to 68 (mean 51) years. Union has been achieved in all of the cases but nonunion of olecranon osteotomy occurred in three patient till last follow-up and we had to remove the implants in 11 patients.

Conclusion

Pin and plate fixation is a simple and effective technique for fixation of the humeral supracondylar nonunions.