Arthroscopic treatment of capitellum fracture of the humerus

Arthroscopic-Assisted Reduction and Percutaneous Fixation for Coronal Shear Fractures of the Distal Humerus: Report of Two Cases

“…They inserted a 3.5-mm-diameter cannulated screw from the anterolateral articular surface of the capitellum and buried it in the articular cartilage. 8 Mitani et al also reported successful results with posteroanteriorly directed headless screws after treating a type 1A fracture via a proximal anteromedial portal and anterolateral portal. 9 The main difference between our method and those in the previous 2 reports is that we only used a single proximal lateral portal.…”

“…8,9 Hardy et al reported successful results in a patient with a type 1A fracture by using 3 lateral portals. They inserted a 3.5-mm-diameter cannulated screw from the anterolateral articular surface of the capitellum and buried it in the articular cartilage.…”

“…4 -7 Arthroscopic reduction and percutaneous screw fixation have also been reported in 2 cases. 8,9 Holt and associates reviewed arthroscopic management of elbow trauma and established criteria for arthroscopic-assisted elbow fracture fixation: displaced 2-part radial head fractures, coronoid fractures, capitellum fractures without comminution, unicondylar distal humeral fractures, AO type C1 intercondylar fractures, medial apophyseal avulsion fractures in a young throwing athlete, and supracondylar humeral fracture with minimal comminution. 10 The authors advocated against arthroscopic management in cases in which adequate stability cannot be achieved.…”

Type II Fracture of the Capitellum

“…For displaced fractures, the options are closed reduction if possible [11], open reduction and internal fixation [2,7,12], or excision [12][13][14]. Arthroscopic internal screw fixation has also been described [5]. Displaced type III fractures should be internally fixed if possible, otherwise excised [6], and type IV fractures usually require internal fixation [8].…”

“…Isolated fractures of the capitellum are rare injuries, accounting for approximately 1% of elbow fractures [1][2][3][4][5]. The usual mechanism of injury is shearing of the capitellum by the radial head, resulting from a fall on the outstretched hand with the elbow extended.…”