The functional outcome after surgical treatment of capitellar fractures: A retrospective review of sixteen cases

Abstract

Objectve The purpose of the study was to evaluate the surgical treatment method and outcomes of capitellar fractures. Methods From December 2004 to December 2006, sixteen patients with a capitellar fracture were included in the study. There were eight males and eight females. According to Bryan and Morrey classification, there were eight type Ⅰ fractures, one type Ⅲ fracture and seven type Ⅳ fractures. In three of type Ⅳ, a separate trochlear fracture fragment with impaction was seen. Distal lateral column posteroinferior metaphyseal comminutiou and/or impaction was observed in association with three fractures including two type Ⅳ fractures and one type Ⅲ fracture. One Mason type Ⅰ radial head fracture occurred in association with an ipsilateral type Ⅳ capiteilum fracture. The patients ranged from sixteen to sixty-five years old, with an average age of 44.9 years. An extensile lateral exposure and articular fixation with cannu-lated compression screws were performed within five days of injury. Clinical, radiographic, and functional el-bow index rating scale of Broberg-Money were evaluated retrospectively. Results The follow-up time ranged from 24 to 36 months,with the mean of 29 months. All fractures healed at an average of 7.9 (range, 6 to 11) weeks without radiographic evidence of osteonecrosis of the fracture fragment. Average arc of motion was 125.8°±16.8° in flexion-extension and 163.1°±10.62° in pronation-supination. The mean Broberg-Mor-rey was 92.0 points, with eight excellent results, seven good results, and one poor result. There were one pa-tient with a minimum of grade 1 radio-capitellar arthrosis.Fifteen of the sixteen adults were able to continue their former professional activities. The patient had persistent postoperative stiffness with a flexion contrac-ture at the last postoperative visit. Conclusion Prompt treatment with anatomic reduction and internal fixa-tion with lag screws followed by early rehabilitation can lead to functional arc and satisfactory outcome. Key words: Humeral fractures; Fracture fixation,internal; Treatment outcome