Elbow stiffness due to malunited capitellum fracture: A case report and the role of 3D printing in surgical management.

Introduction: Elbow stiffness is an uncommon condition that significantly impacting a patient's daily activities. Trauma is the most frequent cause of elbow stiffness. However, capitellum fractures are rare, accounting for approximately 1 % of elbow fractures. They are often misdiagnosed due to nonspecific symptoms and the complex anatomy of the elbow joint.

Case Presentation: We report the case of a 54-year-old female who presented with left elbow stiffness eight months after a traumatic incident. On physical examination, her left elbow extension was +10°, and flexion was restricted to 65°, with no limitation in pronation or supination. Imaging studies revealed a malunited capitellum with osteophytes at the posterolateral site of the olecranon. A 3D-printed model of her elbow was created based on a CT scan to aid surgical planning. She underwent capsulectomy and osteotomy and was stabilized with two bioabsorbable P(L/DL)LA pins. Six months postoperatively, the patient's elbow range of motion was fully restored, and no complications were observed.

Clinical Discussion: Elbow stiffness resulting from the malunion of a capitellum fracture typically necessitates surgical intervention to restore functional movement in the elbow.

Conclusion: Capitellum fractures are uncommon and frequently underdiagnosed, leading to complications such as elbow stiffness and reduced functionality. Early detection is crucial, as delayed diagnosis can result in complex management due to malunion. 3D printing from CT scans helps surgeons accurately evaluate malunions and plan precise surgical interventions.