Neglected Comminuted Fracture of the Capitellum

Abstract

Fracture of the capitellum is a rare injury, accounting for about 1% of the fractures around the elbow. We report the case of a young adult with elbow pain and swelling presenting to us three weeks after the injury. Radiographs suggested a comminuted fracture of the capitellum extending medially to the trochlea. Using the anterolateral approach to the elbow, an open reduction and internal fixation of the fracture with screws was done. The procedure had an excellent functional outcome. Through this case report, we aim to highlight the importance of radiographic assessment and decision-making regarding the surgical approach and choice of the implant in the treatment of comminuted capitellar fractures.

Humeral Capitellum Fractures in Adolescents: A Study of 6 Cases Treated by Open Reduction and Internal Fixation with Bioabsorbable Nails

“…The most popular classification scale of distal humeral shear fractures is the Bryan and Morrey classification [ 8 ], which divides fractures into the four types: type I (known as Hahn–Steinthal fracture) is a osteochondral fracture which involves the capitellum with or without small fragment of trochlea, type 2 (called the Kocher–Lorenz fracture) is a capitellum fracture containing the cartilaginous cap with a small amount of subchondral bone, type 3 is a comminuted fracture of the capitellum, and type 4 (added by McKee et al) [ 9 ] defining an osteochondral fracture of the capitellum with a significant fragment of a trochlea. Coronal plane articular fractures of the distal humerus can be missed, especially based on anteroposterior radiographs [ 10 , 11 ]. True lateral X-rays are most helpful for diagnosis [ 12 , 13 ].…”