Surgical tips and tricks for coronal shear fractures of the elbow

Tarallo, Luigi; Novi, Michele; Porcellini, Giuseppe; Giorgini, Andrea; Micheloni, Gian Mario; Catani, Fabio

doi:10.1007/s00402-020-03500-9

Cited by 14 publications

(13 citation statements)

References 21 publications

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“…The posterior-to-anterior direction can potentially reduce the risk of collapse of the joint surface along with the subchondral bone, which at times is very thin. With collapse, the physiologic anterior offset of the capitellum is altered with subsequent risk of elbow instability due to the altered relationships between primary and secondary elbow stabilizers [ 61 ]. Lopiz et al, reported retrospectively on 18 patients, which were over the age of 65 and treated with either anterior-to-posterior (11 patients) or posterior-to-anterior (nine patients) cannulated screws.…”

Section: Treatment Options and Resultsmentioning

confidence: 99%

“…Elbow instability can be due to either the acute trauma or to surgical exposure, such as releasing the LUCL while extending the Kocher approach [ 13 , 61 ]. Surgical excisions of fracture fragments have limited long-term follow-up reported, although patients may develop progressive valgus instability and chronic pain [ 37 ].…”

Section: Complicationsmentioning

confidence: 99%

“…Although stiffness is common with heterotopic ossification, malunion, prominent implants, infection, arthrosis, and ulnar neuropathy are the attributable causes [ 48 ]. In cases where post-traumatic stiffness is present, arthroscopic release might be an option [ 61 ]. However, a functional ROM is usually obtained without further surgery.…”

Section: Complicationsmentioning

confidence: 99%

“…Elbow instability can be due to either the acute trauma or to surgical exposu as releasing the LUCL while extending the Kocher approach [13,61]. Surgical exc Heterotopic ossification is reported in 0% to 38% of cases.…”

Section: Complicationsmentioning

confidence: 99%

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Coronal Shear Fractures of the Distal Humerus

Bellato

Via

Bachman

et al. 2022

JFMK

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Coronal shear fractures of the distal humerus are rare, frequently comminuted, and are without consensus for treatment. The aim of this paper is to review the current concepts on the diagnosis, classification, treatment options, surgical approaches, and complications of capitellar and trochlear fractures. Computed Tomography (CT) scans, along with the Dubberley classification, are extremely helpful in the decision-making process. Most of the fractures necessitate open reduction and internal fixation, although elbow arthroplasty is an option for comminuted fractures in the elderly low-demand patient. Stiffness is the most common complication after fixation, although reoperation is infrequent.

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Section: Treatment Options and Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Coronal Shear Fractures of the Distal Humerus

Bellato

Via

Bachman

et al. 2022

JFMK

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“…An insertion of the screw from anterior can cause injury to the cartilage surface and can lead to collapsing of fragment. 12,25,26 In the treatment of large capitellar fragments anterior to posterior cannulated headless compression screws may be useful, which have been shown to be biomechanically superior to postero-anterior cannulated lag screws or Herbert screws. 5,13,27 However, with postero-anterior placement of lag screws or Herbert screws than after anteroposterior placement we can get better motion and functional scores.…”

Section: Discussionmentioning

confidence: 99%

Isolated Capitellar Fracture Fixation With Headless Screws in Different Configurations

et al. 2022

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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.

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