Herbert screw fixation of capitellar fractures

From 1993 to 2003, 6 patients with displaced fractures of the humeral capitellum were treated by open reduction and internal fixation of the capitellar fragments with Herbert bone screws. By use of the criteria of Grantham et al, there were 2 type II-A fractures, 1 type II-B fracture, 1 type II-C fracture, and 2 type III-A fractures. A lateral approach was used in 4 patients and a posterior approach with olecranon osteotomy in 2. The elbows were immobilized postoperatively for 4 to 28 days (mean, 13.5 days). We evaluated the range of motion, stability, and pain using the criteria of Grantham et al. The follow-up period ranged from 2.5 to 9.3 years (mean, 5.6 years). All patients had a stable, pain-free elbow with good range of motion at follow-up. All fractures healed, and there was no evidence of avascular necrosis or degenerative change.