Capitellar fractures-is open reduction and internal fixation necessary?

Area of Science:

• Orthopedic surgery
• Traumatology
• Bone healing

Background:

• Capitellar fractures are uncommon elbow injuries.
• Type 1 fractures are typically extra-articular.
• Non-operative management is sometimes considered for specific fracture types.

Purpose of the Study:

• To evaluate the medium- to longer-term outcomes of type 1 displaced capitellar fractures treated non-operatively.
• To assess the efficacy of closed reduction and immobilization for these injuries.

Main Methods:

• Retrospective case series of eight patients (seven adults, one child) with type 1 capitellar fractures.
• Treatment involved closed reduction and four weeks of postreduction cast immobilization.
• Outcomes assessed included radiographic union, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and elbow range of motion.

Main Results:

• All eight fractures achieved union.
• Patients experienced a near-full return of elbow range of motion compared to the uninjured side.
• Mean DASH scores were low (4.36), indicating minimal disability.
• No complications were reported during the follow-up period (average 41.6 months).

Conclusions:

• Closed reduction and cast immobilization represent a successful treatment strategy for type 1 capitellar fractures.
• This approach yields favorable medium- to longer-term results with good functional recovery and no complications.