Surgical Management of Pediatric Capitellar Fractures: A Case Series of Five Patients

Capitellum fractures are rare in pediatric patients and pose unique diagnostic and management challenges due to the presence of developing ossification centers and growth plates. Timely recognition and appropriate treatment are essential to prevent long-term complications such as stiffness, avascular necrosis, or growth disturbances. This case series presents five pediatric patients with capitellum fractures, classified as Dubberley type 2A, detailing their surgical management and their postoperative outcomes. The cases were treated at a single institution over a two-year period. Fractures were classified based on imaging, including plain radiographs and, where needed, computed tomography (CT). The treatment strategy included open reduction and internal fixation with headless screws through a posterolateral approach. The five cases involved patients aged between 11 and 14 years, with mechanisms of injury including falls from height and sports-related trauma. All patients achieved satisfactory functional outcomes, with no reported cases of avascular necrosis or significant growth disturbances at a mean follow-up of 8.8 months. Minor complications included transient stiffness in two patients, which resolved with physiotherapy. In conclusion, capitellum fractures in children, though uncommon, require high clinical suspicion and appropriate imaging for accurate diagnosis. Early and individualized management, tailored to the fracture type and patient needs, can yield excellent outcomes. This case series underscores the importance of a multidisciplinary approach in optimizing care for pediatric elbow injuries.