Introduction: Better understanding of disruption of bony and ligamentous constraints of the radiocapitellar joint in complex capitellum fracture is essential for optimizing the surgical care and outcome. This report highlights the need for modification in surgical fixation technique to address an unusual variant of this rare injury.
Case Report: We report a three-part capitellum fracture pattern with a Y-shaped split of distal humerus with a sheared anterior fragment and a single, large, non-articular posterolateral fragment in a young male patient. Articular fragment was fixed with two countersunk anterior-distal to posterior-proximal oblique screws. Additional screw was used to fix the posterolateral fragment to prevent posterolateral rotational instability. Mayo elbow performance score was 95 with no rotational instability at 2 years follow-up.
Conclusion: Additional fixation of posterolateral fragment in this three-part variant of Bryan and Morrey Type IV capitellum fracture ensured rotational stability and good function.
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http://dx.doi.org/10.13107/jocr.2021.v11.i02.2038 | DOI Listing |
JSES Int
November 2024
Department of Orthopaedic Surgery, University of Iowa, Iowa City, IA, USA.
Background: Limitations to using the knee as donor cartilage include cartilage thickness mismatch and donor site morbidity. Using the radial head as donor autograft for capitellar lesions may allow for local graft harvest without distant donor site morbidity. The purpose of this study is to demonstrate the feasibility of performing local osteochondral autograft transfer from the nonarticular cartilaginous rim of the radial head to the capitellum.
View Article and Find Full Text PDFJ Hand Surg Am
January 2025
Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO. Electronic address:
Purpose: Isolated coronal shear fractures of the distal humerus in adolescents are rare injuries with unique surgical challenges. Respect for the posterior blood supply, open physes, and need for direct visualization to achieve anatomic reduction are critical considerations in surgical fixation. This study presents a case series and a surgical approach used in treating these patients.
View Article and Find Full Text PDFSci Rep
December 2024
Orthopedics Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Jiangxi Hospital Affiliated Children's Hospital of Chongqing Medical University, Chongqing, China.
J Shoulder Elbow Surg
November 2024
Shoulder and Elbow Unit, Department of Orthopaedic Surgery, Hesperia Hospital, Modena, Italy.
Background: In acute radial head fractures (RHFs), a radial head prosthesis can be considered if open reduction and internal fixation are not technically feasible. This study provides the largest long-term clinical and radiologic follow-up study of cemented bipolar Judet prostheses implanted to manage acute RHFs, either isolated and associated with other elbow fractures. We compare their functional and radiographic outcomes to test the hypothesis that the bipolar design can achieve similar results in both groups.
View Article and Find Full Text PDFJBJS Essent Surg Tech
November 2024
Pediatric Hand, Nerve and Microsurgery, Barcelona Children's Hospital, HM Hospitales, Barcelona, Spain.
Background: Radial neck fractures account for 1% of all pediatric fractures and 5% to 10% of pediatric elbow fractures. The mechanism of injury is typically a fall with the elbow in hyperextension and the forearm in supination. A valgus force compresses the radial head against the capitellum, causing a radial neck fracture.
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