Capitellum fracture: Outcome of surgical treatment

Abstract

Background: Fractures of the capitellum humeri are uncommon injuries accounting for only 1% of all fractures and around 6% of fractures close to the elbow. As the complex nature of capitellar fractures various treatment options have evolved and open reduction and internal fixation (ORIF) with Herbert screw, Biodegradable screw, suture anchor were considered. Purpose of study was to find the mechanism of injuries and clinical outcome of capitellar fractures managed by ORIF. Method: A prospective follow-up study was planned on eight patients of capitellar fractures admitted at Mahatma Gandhi Medical College & Hospital, Sitapura, Jaipur. These patients were followed-up for a period of twelve months and Mayo Elbow Performance Index was assessed. Results: Study includes 08 patients with age range from 24 years to 67 years with mean age 42.8±14.55 years. Females (62.5%) were affected more than males (37.5%). Mechanism of injury were road traffic accident in 05(62.5%), fall on outstretched arm in 02 (25%) and direct blow to the elbow in 01 (12.5%) cases. The average loss of ROM of the affected elbows was 12° of flexion-extension and 6° of supination-pronation compared with the unaffected elbows. The average MEPI Score was 91.8 ± 7.88 (range, 75 to 100) with 06 excellent and 02 good. No evidence of post operative complications was found at the end of follow-up. Conclusion: Capitellum fractures are rare and complex articular injuries. Road traffic accidents are most common mechanism responsible for such injuries. ORIF is recommended to achieve good clinical outcome but may end into stiffness and decreased range of motion.