Is surgery always necessary? Successful closed reduction of displaced capitellum fracture: A case report

Distal humerus shear fractures are uncommon intra-articular injuries including capitellum fractures, most frequently resulting from a fall on an outstretched hand where the radial head pushes the capitellum while it engages in a full elbow extension and axial load. Displaced fractures, particularly those classified as Dubberley Type 2A capitellum fracture, are typically managed surgically with open reduction and internal fixation (ORIF) to restore articular congruity and allow early mobilization. Successful nonoperative treatment in such cases remains limited with high complication rates. A 35-year-old male presented after a fall onto an outstretched hand with a painful locked elbow. Radiographs demonstrated a displaced capitellum fracture (Dubberley Type 2A), which was successfully treated with closed reduction under local anesthesia and fluoroscopic guidance, followed by immobilization and a structured rehabilitation program. At 1-year follow-up, the patient had a pain-free elbow with satisfactory range of motion and no evidence of instability, avascular necrosis, or radiographic abnormalities. This case suggests that, in carefully selected patients, closed reduction may represent a viable alternative to open fixation for displaced capitellum fractures when anatomical reduction can be achieved and maintained with close follow-up and rehabilitation.