The impact of associated injuries and fracture classifications on the treatment of capitellum and trochlea fractures: A systematic review and meta-analysis

He, Shu-Kun; Xu, Long; Guo, Jinhai; Liao, Jingping; Qin, Tingwu; Huang, Fuguo

doi:10.1016/j.ijsu.2018.04.028

Cited by 10 publications

(9 citation statements)

References 32 publications

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“…Stable fixation and anatomical articular reduction of Bryan and Morrey Type IV fracture allows early mobilization and good outcome [ 5 ]. Management of this complex fracture pattern can be associated with HO, avascular necrosis, and chronic posterolateral rotational instability secondary to ligamentous injury or Osborne-Cotterill osteochondral lesion [ 5 , 6 ]. Posterior column instability and associated injuries have a direct bearing on the surgical outcome.…”

Section: Discussionmentioning

confidence: 99%

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An Unusual Bryan and Morrey Type IV Capitellum Fracture with Posterolateral Rotational Instability: A Case Report

Chaganty¹,

Meril²,

Sundass³

et al. 2021

JOCR

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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. Keywords: Complex capitellum fracture, anterior-posterior fixation, elbow posterolateral rotatory instability, posterolateral capitellum fracture.

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Section: Discussionmentioning

confidence: 99%

“…Anatomical reduction and rigid fixation with at least two lag screws with preservation of posterior soft-tissue sleeve is advocated for such fractures [ 4 ]. Coexisting injuries may need additional fixation to ensure elbow stability and are associated with poorer outcome [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

An Unusual Bryan and Morrey Type IV Capitellum Fracture with Posterolateral Rotational Instability: A Case Report

Chaganty¹,

Meril²,

Sundass³

et al. 2021

JOCR

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“…For the Dubberley classification, the only significant difference was in MEPI scores between subtype A and subtype B fractures. 65…”

Section: Discussionmentioning

confidence: 99%

Coronal Shear Fractures of the Distal Humerus: A Review of Diagnosis, Treatment, and Outcomes

Fram

Seigerman

Ilyas

2019

Hand (New York, N,Y.)

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Fractures of the capitellum and trochlea are uncommon fractures of the elbow and can be challenging to treat due to their size, location, and articular nature. Because of their intra-articular nature and predilection toward displacement, these fractures are typically treated operatively. Furthermore, capitellum fractures have high rates of associated injuries, including radial head fractures or lateral collateral ligament injury in ~30% to 60% of patients. In addition to open reduction internal fixation, operative options include fragment excision, arthroscopic assisted reduction and fixation, and elbow arthroplasty. In this article, we undertake a comprehensive literature review of capitellum fractures of the distal humerus, in an attempt to summarize the existing body of evidence and propose areas of future study.

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“…Capitellar fractures are relatively uncommon, accounting for 1% of all elbow fractures and 6% of fractures of the distal humerus [1][2][3][4][5][6][7][8] . Due to a more frequent occurrence of cubitus valgus or cubitus recurvatum the incidence is higher in the female population [4] . In 1853, Hahn was the first one to describe a fracture of the capitellum [3] .…”

Section: Introductionmentioning

confidence: 99%

“…Or capitellar fractures can result from a spontaneous reduction after a posterolateral elbow subluxation or dislocation. The capitellum is then sheared off by the radial head or coronoid process [1,3,4,8] . Several classification systems have been described.…”

Section: Introductionmentioning

confidence: 99%

Fracture of the capitellum with an associated fracture of the lateral humeral condyle: A case report

Truyers¹,

Meijer²,

Walbeehm³

2021

Int. J. Case Rep. Orthop.

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Isolated fractures of the capitellum humeri are rare and can be difficult to diagnose. Associated bone and soft tissue injuries are common. Mostly, a concomitant lateral collateral ligament injury or a radial head fracture is reported. Open reduction and internal fixation are accepted as the favored treatment to facilitate anatomic reduction. Missed diagnosis or inadequate treatment of capitellar fractures can led to the development of advanced degenerative changes, limitation of motion and pain. We present the case of an eighteen-year-old male with a Bryan and Morrey type I capitellar fracture in association with a fracture of the lateral humeral condyle. Fractures were treated with open reduction and internal fixation, using a headless compression screw and cannulated screws. To our knowledge this is the first case report to describe the treatment of a capitellar fracture with an associated fracture of the lateral humeral condyle.

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The impact of associated injuries and fracture classifications on the treatment of capitellum and trochlea fractures: A systematic review and meta-analysis

Abstract: The associated injury of fracture may have a negative impact on the functional outcomes of elbow. And Dubberley classification is more suitable to classify this kind of fracture. Furthermore, high-quality studies are required to attain robust evidence.

Cited by 10 publications

References 32 publications

An Unusual Bryan and Morrey Type IV Capitellum Fracture with Posterolateral Rotational Instability: A Case Report

An Unusual Bryan and Morrey Type IV Capitellum Fracture with Posterolateral Rotational Instability: A Case Report

Coronal Shear Fractures of the Distal Humerus: A Review of Diagnosis, Treatment, and Outcomes

Fracture of the capitellum with an associated fracture of the lateral humeral condyle: A case report

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