Open reduction and internal fixation for capitellum fractures in adolescents

Abstract

Objective To report the clinical outcomes of open reduction and internal fixation for capitellum fractures in adolescents. Methods From January 2010 to January 2015, 14 adolescents with capitellum fracture were admitted to our department. They were 12 males and 2 females, aged from 12 to 16 years (13.7 years). By the Dubberley classification, we had 2 cases of type ⅠA, 8 cases of type ⅡA, 3 cases of type ⅢA and one of type ⅢB. We summarized their clinical characteristics and injury mechanisms. At the last follow-up, the therapeutic efficacy was assessed by the Mayo elbow function scores, and the ranges of motion of the elbow and forearm on the affected side were recorded. Results The 14 patients obtained an average follow-up of 12 months (from 6 to 18 months). All the cases achieved fracture union within 3 months, but malunion appeared in one. At the last follow-up, the ranges of flexion and extension of the affected elbow averaged 120.6° (from 110° to 135°), and the ranges of lateral rotation of the affected forearm averaged 160.3° (from 150° to 175°). According to the Mayo scores at the last follow-up, the elbow function was rated as ex-cellent in 12 and as good in one. Mild traumatic arthritis occurred in 3 cases. Conclusions Capitellum fractures in adolescents are often Dubberley type A ones without a complicated fracture of the posterior condyle. Usually, the capitellum is impacted by the radial head in the process of elbow extension with valgus stress. After definite diagnosis, open anatomical reduction and reasonable and reliable internal fixation can result in good clinical results. Key words: Elbow joint; Fracture fixation, internal; Adolescent; Injury mechanism