Capitellum Fracture Fragment Excision: a Case Series

Abstract

Background

Fractures of the capitellum are rare injuries, and few studies have reported the results of fragment excision.

Questions/Purposes

The purpose of this study was to determine range of motion and short-term clinical outcomes for patients treated with capitellum excision.

Methods

A retrospective review was performed to identify all patients with an isolated capitellum fracture who underwent excision as definitive treatment at our institutions. Mechanism of injury, associated elbow injuries, type of capitellum fracture, complications, and postoperative outcomes including final elbow range of motion (ROM), elbow instability, and Disabilities of the Arm, Shoulder and Hand (DASH) score were recorded.

Results

Four patients met the inclusion and exclusion criteria of this study. All patients were female with an average age of 69 years (range 42–85). Based on the Bryan and Morrey classification system, three (75%) fractures were classified as type I and one (25%) fracture as type III. The average clinical follow-up was 11 months. Final examination demonstrated a mean elbow range of motion from 14° (range 0–30) of extension to 143° (range 130–160) of flexion. All patients had full forearm rotation, and there was no clinical evidence of elbow instability. The average DASH score was 18.3 (12.5–24.2) at final follow-up.

Conclusion

Excision of the capitellum, much like excision of the radial head, results in acceptable short-term outcome scores and elbow range of motion in patients with fractures that are not amenable to open reduction and internal fixation.

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Disclosures

Conflict of Interest

Matthew R. Garner, MD; Patrick C. Schottel, MD; Robert N. Hotchkiss, MD; Aaron Daluiski, MD; and Dean G. Lorich, MD have declared that they have no conflict of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was waived from all patients for being included in the study.

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Correspondence to Matthew R. Garner MD.

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Level of Evidence: Treatment Level IV

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Garner, M.R., Schottel, P.C., Hotchkiss, R.N. et al. Capitellum Fracture Fragment Excision: a Case Series. HSS Jrnl 11, 204–208 (2015). https://doi.org/10.1007/s11420-015-9452-x

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Keywords

  • capitellum fracture
  • capitellum excision
  • elbow fracture
  • elbow trauma