Treatment of supracondylar humeral non-union by bone autograft and Hoffmann II external fixation

Supracondylar humeral nonunions are difficult to heal by internal fixation. Prosthetic arthroplasty is a solution in elderly patients. Both therapeutic options are contraindicated in the case of an infection. The article reports bone autografting and Hoffmann humero-humeral and temporary humero-ulnar Hoffmann external fixation. In our series of seven cases, there was only one minor complication, a benign pin-site infection. There were neither neurovascular complication nor loss of reduction. Solid bone healing was obtained in all patients after an average of 5.2 months (range, 2.5 to 6 months). External fixation is a form of "biologic" fixation, as there is no implant apposed on the bone fragments, preventing their revascularization. This easy technique allows to correct the preoperative deformity while providing sufficient stability to allow active mobilization. Temporary elbow bridging does not seem to cause significant stiffening of the joint. (C) 2019 Elsevier Masson SAS. All rights reserved.