Fractures of the Capitellum and Trochlea

Guitton, Thierry G.; Doornberg, Job N.; Raaymakers, E. L. F. B.; Ring, David; Kloen, Peter

doi:10.2106/jbjs.g.01660

Cited by 82 publications

(59 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Spontaneous reduction after elbow instability will also lead to injury pattern. The incidence is higher among women because of high rate of osteoporosis and carrying angle difference than men [5][6][7] . Usually the associated injuries are of lateral collateral ligament, trochlea, epicondyle, condylar and elbow dislocation [3][4][5][6][7][8] .…”

Section: Relevant Anatomymentioning

confidence: 99%

“…The incidence is higher among women because of high rate of osteoporosis and carrying angle difference than men [5][6][7] . Usually the associated injuries are of lateral collateral ligament, trochlea, epicondyle, condylar and elbow dislocation [3][4][5][6][7][8] . Lateral collateral ligament injury is seen in 40% and radial head fracture is reported in 30% of the patients [2,8,9] .…”

Section: Relevant Anatomymentioning

confidence: 99%

“…These injuries result from axial loading of the capitello-trochlear area by the forces transmitted through the radial head and could be associated with more complex distal humeral fractures and dislocation with concomitant ligamentous injuries [1,3] . The complexity of these fractures in recent times has been better appreciated by digital imaging and computed tomographic scans [3][4][5][6] . Open reduction and internal fixation provides anatomical reduction, stability and early mobilisationand has become preferred treatment.…”

Section: Introductionmentioning

confidence: 99%

“…The intraarticular and complex nature of these fractures makes optimal surgical exposure and implants debatable. The surgical approach and reconstruction of articular surfaces is technically challenging and several extensile approaches and fixation devices for reconstruction of articular surfaces are propagated in recent case series [3][4][5]8] . For articular surface reconstruction various implants including headless screws, miniscrews can be used.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Coronal shear fractures of distal humerus: Diagnostic and treatment protocols

Singh¹,

Singh²

2015

WJO

View full text Add to dashboard Cite

Coronal shear fractures of distal humerus involving the capitellum and the trochlea are rare injuries with articular complexity, and are technically challenging for management. With better understanding of the anatomy and imaging advancements, the complex nature of these fractures is well appreciated now. These fractures involve metaphysealcomminution of lateral column and associated intraarticular injuries are common. Previously, closed reduction and excision were the accepted treatment but now preference is for open reduction and internal fixation with an aim to provide stable and congruent joint with early range of motion of joint. Various approaches including extensile lateral, anterolateral and posterior approaches have been described depending on the fracture pattern and complexity. Good to excellent outcome have been reported with internal fixations and poor results are noted in articular comminution with associated articular injuries. Various implants including headleass compression screws, minifragment screws, bioabsorbable implants and column plating are advocated for reconstruction of these complex fractures. Inspite of articular fragments being free of soft tissue attachments the rate of osteonecrosis and osteoarthritis is reported very less after internal fixation. This article summarizes the diagnostic and treatment strategies for these rare fractures and recommendations for management.

show abstract

Section: Relevant Anatomymentioning

confidence: 99%

Section: Relevant Anatomymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coronal shear fractures of distal humerus: Diagnostic and treatment protocols

Singh¹,

Singh²

2015

WJO

View full text Add to dashboard Cite

show abstract

“…The sub-chondral bone of the trochlea creates the double arc and when this sign is present it signifies that a part of the trochlea is also involved. 3 Radiological diagnosis is difficult in a child because the capitellum is not fully ossified and fused before the age of 9-10 years. Other authors have suggested an oblique radiograph to detect this injury.…”

Section: IVmentioning

confidence: 99%