INTERNAL FIXATION OF TYPE I CAPITELLUM FRACTURE WITH HEADLESS SCREWS: A CASE REPORT

Background: Capitellum fractures are relatively rare. Distal humeral fractures that include capitellum and trochlea constitute approximately 6% of all distal humeral fractures and 1% of all elbow fractures. Despite the rarity of these injuries, an increasing number of clinical series have emerged, enhancing our understanding of these fractures.Case Report: A 26-year-old woman came to the emergency department with complaints of swelling and localized pain on the lateral side of her left elbow 2 hours after she fell off her motorcycle. Routine imaging such as plain radiographs and computed tomography scanning confirmed the fracture. She underwent open reduction and internal fixation surgery, stabilization of articular fragments with headless screws, and was fixated by a back slab and arm sling. The patient was also encouraged to do early elbow mobilization to avoid contractures and joint stiffness, routine follow-up every two weeks for a ROM evaluation. Preoperative Mayo Elbow-Performance Index score (MEPI) was 15, and postoperative 100.Discussion: The aim of capitellum fracture treatment is anatomical reconstruction and fixation to reduce the risk of non-union. In this case, we performed open reduction, secured two headless screws, which allow rigid fixation at the fracture site, provide fracture site compression through variable thread pitch design, and remained not removed later. These screws are suitable for use in anteroposterior and posteroanterior directions.Conclusion: The patient at two months follow-up has shown significant improvement. Accurate reduction, stable fracture fixation, and early postoperative mobilization were reported to provide good results with a MEPI score of 100.

An Unusual Bryan and Morrey Type IV Capitellum Fracture with Posterolateral Rotational Instability: A Case Report

Introduction: Better understanding of disruption of bony and ligamentous constraints of the radiocapitellar joint in complex capitellum fracture is essential for optimizing the surgical care and outcome. This report highlights the need for modification in surgical fixation technique to address an unusual variant of this rare injury. Case Report: We report a three-part capitellum fracture pattern with a Y-shaped split of distal humerus with a sheared anterior fragment and a single, large, non-articular posterolateral fragment in a young male patient. Articular fragment was fixed with two countersunk anterior-distal to posterior-proximal oblique screws. Additional screw was used to fix the posterolateral fragment to prevent posterolateral rotational instability. Mayo elbow performance score was 95 with no rotational instability at 2 years follow-up. Conclusion: Additional fixation of posterolateral fragment in this three-part variant of Bryan and Morrey Type IV capitellum fracture ensured rotational stability and good function. Keywords: Complex capitellum fracture, anterior-posterior fixation, elbow posterolateral rotatory instability, posterolateral capitellum fracture.

A rare case report of type IV capitellum fracture in a young female managed by a single Herbert screw fixation

<p class="abstract">Isolated coronal shear fractures of capitellum are very rare, accounting for nearly 1% of all elbow fractures. There are various approaches and implants documented for management of such fractures. One of them is lateral Kocher’s approach and Herbert screw fixation. Our case report is strengthening this approach and Herbert screw fixation and shows good short term functional outcome along with radiological union.</p><p class="abstract"> </p>