Capitellar fracture

Capitellar Fracture

 

Uncommon fracture which is difficult to diagnose if fracture fragment is small

 

Elbow Capitellar FractureCapitellar Fracture CT SagittalCapitellar Fracture CT Axial

 

Type I

- Hans Steinthal fracture

- fracture of the capitellum in the coronal plane

- involves large part of the osseous portion of capitulum

- fracture hinges anteriorly between radial head and radial fossa producing a block to flexion

 

Management

 

If closed reduction is obtained, then reduction is usually stable with elbow flexion

 

Open reduction

 

A. Posterolateral / Kocher approach

- between aconeus and ECU

 

B. Lateral approach

- between EDC and ECRB

- may place PIN at increased risk

 

One or two headless compression screws

- front to back

- buried

 

Capitellar Fracture ORIF0001Capitellar Fracture ORIF0002

 

Type II

- Kocher Lorenz fracture               

- affects primarily articular cartilage and very little underlying bone

- these usually cause few subsequent joint problems

 

Management

- healing potential is minimal & excision is recommended