Navigating a Rare Type IV Capitellar fracture: A Case Report and Comprehensive Literature Review.

Abstract

Capitellar fractures are rare, it accounts 1% of elbow fractures, and can be challenging to diagnose initially. Distinctive "double arc sign" on lateral elbow radiograph is pathogonomic. 3D CT scans is . ORIF is the preferred treatment, but the choice of fixation methods lacks consensus, although headless compression screws are commonly used. This case report presents a Type IV capitellar fracture in a 14-year-old boy resulting from a fall. The patient underwent successful ORIF using 4.0mm cannulated screws inserted posterior to anterior without penetrating joint surface, leading to complete functional recovery. At the 6-month follow-up, the patient exhibited robust healing without signs of capitellar avascular necrosis (AVN).The case underscores the significance of clinical suspicion and meticulous radiographic evaluation to avoid overlooking capitellar fractures. Moreover, it showcases the effectiveness of cannulated screws as a viable alternative in the absence of headless compression screws, offering comparable stability and excellent functional outcomes.