Isolated Capitellar Fracture Fixation With Headless Screws in Different Configurations

Abstract

Introduction We evaluated the clinical and radiological outcomes of capitellar fractures treated with modified screw insertion (inserting the first fixation screw anteroposteriorly and the second screw posteroanteriorly), a technique that can be applied with a minimally invasive lateral elbow approach. Materials and Methods Twenty-one isolated capitellum fractures that were surgically treated were included in the study. Fixation was achieved with two headless cannulated compression screws placed in anteroposterior and posteroanterior order using the modified lateral elbow approach. The Broberg-Morrey rating system was used to assess the post-operative functional status of the patients. Results According to the Broberg-Morrey criteria, the mean score was 92.7 (77-100) and 13 cases had excellent, 7 had good, and 1 had fair results. None of the patients developed avascular necrosis or heterotopic ossification. According to the Broberg-Morrey arthrosis score, two cases had Grade 1 and one had Grade 2 arthrosis. One patient had a superficial wound site infection that was treated with antibiotics, and in one case a 60° extension loss was observed in the elbow. Conclusion Treatment of isolated capitellar fractures with 2 headless screws placed anteroposteriorly and posteroanteriorly can provide stable fixation and is less traumatic for the elbow joint. Level of Evidence IV; Therapeutic Studies - Investigating the results of treatment.

Clinical Outcomes and Management Strategies for Capitellum and Trochlea Fractures: A Systematic Review

“…The advantages of AP screws are related with the ability to enhance the amounts of threads in the fractured-free fragment and better biomechanical stability. 42 The postoperative protocol often included some period of immobilization. Earlier studies appeared to use above elbow splints for longer periods of time.…”

“… 3 , 7 , 11 More recent studies have displayed a trend towards shorter periods of immobilization with a maximum time frame of 2 weeks. 28 , 29 , 35 , 40 , 42 In fractures amenable to rigid fixation, postoperative immobilization was not utilized, and earlier range of motion was allowed. 16 , 41 , 44 …”

“…3,7,11 More recent studies have displayed a trend towards shorter periods of immobilization with a maximum time frame of 2 weeks. 28,29,35,40,42 In fractures amenable to rigid fixation, postoperative immobilization was not utilized, and earlier range of motion was allowed. 16,41,44 When analyzing outcome scores, it is crucial to note that they reflect mild-to-moderate functional limitations, with more complex patterns such as in BM IV resulting in even more functional deficits.…”