- Discussion:
- see lateral condyle fracture
- uncommon frx which is difficult to diagnose if fracture frag is small;
- any effussion within the elbow joint together with displacement of fat pads suggests either a capitulum fracture or
nondisplaced frx of radial head;
- Type I: (Hans Steinthal Frx)
- type I is fracture of the capitullum in the coronal plane;
- involes large part of the osseous portion of capitulum, w/ little or no involvement into the lateral aspect of the trochlea;
- frx hinges anteriorly between radial head and radial fossa producing a block to flexion;
- frx involves most of the anterior articular surface of the capitellum and the trochlea;
- often results from a fall from a height;
- radiographs:
- double arc sign seen on lateral views;
- oblique views may be required to visualize the main frx line;
- ref: Capitellar fracture in a child: the value of an oblique radiograph. A case report
- closed treatment:
- if closed reduction is obtained, then reduction is usually stable w/ elbow flexion;
- references:
- Closed Reduction and Early Mobilization in Fractures of the Humeral Capitellum.
- Closed reduction of coronal fractures of the capitellum
- Capitellar Fractures - Is ORIF Necessary?
- operative treatment: excision of fragment
- Effect of coronal shear fractures of the distal humerus on elbow kinematics and stability
- Fracture of the capitulum humeri. Treatment by excision.
- percutaneous pin fixation:
- Capitulum Fracture: Result of Percutaneous Fixation and Review of Literature
- operative treatment: ORIF
- extended Kocher approach to the elbow;
- hardware may include Herbert bone screw or 4.0 mm cancellous screws (which are inserted from posterior to anterior)
- displaced frxs are treated with ORIF with one or two Herbert screws;
- references:
- Nonunion of Operatively Treated Capitellum and Trochlear Fractures
- Reconstruction of radial capitellar fractures using fine-threaded implants (FFS).
- Open reduction and internal fixation of capitellar fractures with headless screws
- Open reduction and internal fixation of capitellar fractures with headless screws. Surgical technique.
- Large coronal shear fractures of the capitellum and trochlea treated with headless compression screws.
- Fractures of the Capitellum and Trochlea
- Minimal Invasive Technique in Capitellum Fracture Treatment
- Hahn-Steinthal fracture: a case report
- Type II: (Kocher Lorez Frx);
- affects primarily anterior articular cartilage and very little underlying bone;
- these usually cause few subsequent joint problems;
- type II, or Kocher Lorenz fracture, is a sleeve fracture of articular surface with little osseous bone;
- healing potential is minimal & excision is recommended;
- references:
- Type II Fracture of the Capitellum. Operative Treatment of a Rare Injury
- Effect of coronal shear fractures of the distal humerus on elbow kinematics and stability
- Arthroscopic excision of type II capitellar fractures
- The often-missed Kocher-Lorenz elbow fracture
- Type III: (Broberg and Morrey);
- comminuted frx of the capitellum;
- operative treatment: excision of fragment
- Effect of coronal shear fractures of the distal humerus on elbow kinematics and stability
- Type IV:
- ref: Type 4 capitellum fractures: Diagnosis and treatment strategies
Capitellar Fractures in Children and Adolescents: Classification and Early Results of Treatment
Fractures of the capitellum.
Surgical treatment of fractures of the capitellum in adults: a modified technique.
Surgical management of fracture of the capitulum humeri.
Fracture of the capitulum humeri.
Internal fixation of a capitellar fracture using Herbet screws. A case report.
Coronal shear fractures of the distal end of the humerus.
Multiplane fracture of the distal humerus.
Combined shear fractures of the trochlea and capitellum associated with anterior fracture-dislocation of the elbow.
Closed Reduction and Early Mobilization in Fractures of the Humeral Capitellum.