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Capitellum and Capitellar-Trochlear Shear Injury in Children
Naum Simanovski1, Roy S Horowitz1, Vladimir Goldman1
1Orthopedic Department, Hadassah Medical Center, Jerusalem, Israel; and.
Surgical repair of pediatric capitellar fractures using cannulated headless screws yielded good outcomes. Associated osseoligamentous injuries may negatively impact prognosis for these elbow fractures.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Capitellar fractures are uncommon in pediatric patients.
- Surgical management aims to restore elbow function and prevent long-term complications.
Purpose of the Study:
- To report clinical results of surgical intervention for pediatric capitellar fractures.
- To highlight surgical approaches, instruments, and prognostic factors.
Main Methods:
- Retrospective descriptive case-series study of 12 pediatric patients (2017-2021).
- Surgical intervention involved open reduction and internal fixation, primarily with cannulated headless screws.
- Functional outcomes assessed using Mayo Elbow Performance Score; arthrosis evaluated with Bromberg and Morrey system.
Main Results:
- All fractures healed within 5-7 weeks.
- Mean Mayo Elbow Performance Score was 98.
- Three patients developed arthrosis; one experienced capitellar osteonecrosis.
Conclusions:
- The Kocher approach with 2-3 retrograde cannulated screws is suitable for isolated capitellar fractures.
- Transolecranon approach with 3 cannulated screws is effective for capitellar-trochlear shear fractures.
- Osseoligamentous injuries are a potential unfavorable prognostic factor.
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