Capitellar Fractures

Living reference work entry


Fracture of the capitellum is rare accounting for 1% of elbow injuries. It involves patients from 12 years of age and older. The most common mechanism is fall on an outstretched hand that results in an axial compressive force that is transmitted to the capitellum by the radial head. This mechanism of trauma causes fracture in the coronal plane of the humeral capitellum. In fact, Bryan and Morrey (Fig. 3) drafted the most popular classification of capitellar fractures: type I (Hans-Steinthal) coronal shear fracture resulting in an osteochondral fragment, type II (Kocher-Lorenz) coronal shear fracture resulting a cartilaginous fragment, type III multifragmentary fracture, and type IV (Mckee modification type) coronal shear fracture that includes the capitellum and trochlea. The treatment is mostly surgical, with a wide variety of access options. Some of them include lateral, extended lateral, anterolateral, and posterior. We do consider extended lateral as being the best choice, because it provides the most accurate angle to ensure anatomic reduction and stable internal fixation. The fixation must be stable enough to encourage early mobility and prevent eventual complications, such as elbow contracture, nonunion, and arthrosis.

References and Suggested Readings

  1. Bryan RS, Morrey BF (1985) Fractures of the distal humerus. In: Morrey BF (ed) The elbow and its disorders. Saunders, Philadelphia, pp 325–333Google Scholar
  2. Letts M, Rumball K, Bauermeister S, Mcintyre W, D’astous J (1997) Fractures of the capitellum in adolescents. J Pediatr Orthop 17(3):315–320PubMedPubMedCentralGoogle Scholar
  3. Mckee MD, Jupiter JB, Bamberger HB (1996) Coronal shear fractures of the distal end of the humerus. J Bone Joint Surg Am 78(1):49–54CrossRefPubMedGoogle Scholar
  4. Ruchelsman DE, Tejwani NC, Kwon YW, Egol KA (2008) Open reduction and internal fixation of capitellar fractures with headless screws. J Bone Joint Surg Am 90(6):1321–1329CrossRefPubMedGoogle Scholar
  5. Trinh TQ, Harris JD, Kolovich GP et al (2012) Operative management of capitellar fractures: a systematic review. J Shoulder Elb Surg. American Shoulder and Elbow Surgeons ... [et Al.], 21(11):1613–1622CrossRefGoogle Scholar
  6. Vaishya R, Vijay V, Jha GK, Agarwal AK (2016) Open reduction and internal fixation of capitellar fracture through anterolateral approach with headless double-threaded compression screws: a series of 16 patients. J Shoulder Elb Surg. American Shoulder and Elbow Surgeons ... [et Al.], 25(7):1182–1188CrossRefGoogle Scholar

Authors and Affiliations

  1. 1.Hospital do TrabalhadorCuritibaBrazil
  2. 2.Pontifícia Universidade Católica da Paraná – PUCPRCuritibaBrazil

Section editors and affiliations

  • Richard Reynolds
    • 1
  1. 1.Division of Orthopedic SurgeryNemours Children’s Specialty CarePensacolaUSA

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