- Discussion:
- 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;
- if closed reduction is obtained, then reduction is usually stable w/ elbow flexion;
- displaced frxs are treated with ORIF with one or two Herbert screws;
- 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;
- Type III: (Broberg and Morrey);
- comminuted frx of the capitellum;
- Coronal Shear Frx:
- 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;
-
treatment:
- 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);
Fractures of the capitellum.
Surgical treatment of fractures of the capitellum in adults: a modified technique.
Fractures of the capitellum.
Surgical management of fracture of the capitulum humeri.
S. Collert.
Acta Orthop. Scand. Vol 48. 1977. p 603-606.
Fracture of the capitulum humeri.
Internal fixation of a capitellar fracture using Herbet screws: A case report.
LA Simpson and RR Richards.
CORR. Vol 209. 1986. p 166-168.
Some vagaries of the capitellum.
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.
Inoue G.
Horii E. Journal of Orthopaedic Trauma.
6(3):373-5, 1992.
Herbert screw fixation of a capitellum fracture. A case report and review.
Silveri CP.
Corso SJ.
Roofeh J. CORR
(300):123-6, 1994 Mar.
