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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 3/2014

01-06-2014 | Original Article

Posterior fixation of type IV humeral capitellum fractures with fully threaded screws in adolescents

Authors: T. Kurtulmus, N. Saglam, G. Saka, C. C. Avci, F. Kucukdurmaz, F. Akpinar

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2014

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Abstract

Purpose

Humeral capitellum fractures comprise approximately 1% of all elbow fractures. In this study, we examined the clinical, radiographic, and functional outcomes following operative stabilization of Bryan and Morrey type IV fractures of the capitellum in adolescents. We applied headless cannulated screws in a posteroanterior direction without damaging the articular cartilage surface of the fractures.

Methods

Eight adolescent patients (six male, two female) with a mean age of 15 ± 2.1 years (range 13–18 years) were treated for type IV (McKee) humerus capitellum fractures. In the preoperative radiological evaluation, anteroposterior and lateral radiographs and computed tomography (CT) images were performed. A lateral surgical approach was used, and cannulated fully threaded headless screws were applied in a posteroanterior direction as fixation materials in the fracture reduction. The Mayo Elbow Performance Score was used in the evaluation of elbow joint functions.

Results

Patients were followed up for a mean of 24.6 months. Fracture union was achieved at a mean of 5 ± 0.92 weeks (range 4–6 weeks). The mean elbow extension flexion arc was 135° ± 13.47° (range 110°–150º) and the mean pronation supination arc was 156° ± 4.43° (150°–160°). In one patient, there was nonconformity in the humerus trochlea and in another patient, there was keloid formation on the surgical scar. All patients attained excellent results according to the Mayo Elbow Performance Score.

Conclusions

In the treatment of type IV capitellum fractures in adolescents, open reduction with a lateral surgical approach and fixation using posteroanterior directed, cannulated, fully threaded, headless screws is a reliable method to achieve a pain-free functional elbow joint.
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Metadata
Title
Posterior fixation of type IV humeral capitellum fractures with fully threaded screws in adolescents
Authors
T. Kurtulmus
N. Saglam
G. Saka
C. C. Avci
F. Kucukdurmaz
F. Akpinar
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 3/2014
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-013-0332-0

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