Outcome of Open Reduction and Internal Fixation with K Wire and Blocking Screw for the Management of Capitellum Fractures

Author(s): Bipul Kumar Das, Manash Chandra Sarker, Raquib Mohammad Manzur, Naima Ferdoushi, Mani Sanker, Mohammad Zahid Hasan, Md. Mohiuddin, Md. Jahangir Alam

Background: Capitellar fractures are rare injuries. Due to its anatomic location, it is commonly fractured due to a fall on an outstretched hand.

Material and methods: 12 patients were evaluated retrospectively. Type I & type IV fractures of Bryan and Morrey classification system were selected. Extensile lateral approach was used and fracture was fixed with K-wire and blocking screws. This prospective and multicenter based study was conducted at national institute of traumatology and orthopedic rehabilitation (NITOR) and private hospitals outside NITOR, Dhaka, Bangladesh, between January 2018- July 2023. 12 patients were evaluated purposively. Type I & type IV fractures of Bryan and Morrey classification system were selected.

Results: 8 out of 12 patients were female and their mean age was 30.25 years (range 16-43). The radiographic union was noticed between 6 and 16 weeks, with a mean ± SD of 9.58 ± 3.02 weeks. The elbow's mean flexion was 120° (range 100-130°) and mean extension was 11.25° (range 0-30°). Seven patients (58.34%) had an excellent and good outcome based on the Mayo Elbow Performance Score (MEPS), two (16.67%) had a fair outcome, and two (16.67%) had a poor outcome.

Conclusion: Capitellum fractures can be effectively managed by K-wire and blocking screws with minimal complications.