Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

Abstract

Objective The aim of this study is to analyze the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in adolescents. Methods We retrospectively analyzed the clinical and imaging data of 15 adolescents with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system. Results Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All adolescents completed a 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient. Conclusion Open reduction with Herbert screw fixation via the anterior approach is a feasible surgical method for the treatment of coronal fractures of the capitellum in adolescents. Levels of evidence Therapeutic, retrospective study-Level IV

Shear fractures of the capitellum in children: a case report and narrative review

“…We carried out a narrative review of the pediatric literature for capitellar shear fractures (shown in Table 1 ). Most of the literature consists of case reports ( 5 – 8 , 13 , 16 , 17 , 20 – 23 , 25 – 27 , 29 – 31 , 33 , 38 ), followed by a smaller number of retrospective case series ( 9 , 18 , 19 , 24 , 28 , 32 , 34 – 37 ). The retrieved literature showed a bimodal distribution of these fractures, with a first peak in childhood (<10 years) ( 7 , 17 , 20 , 31 ) and a second one, the most representative, in pre-adolescents and adolescents ( 5 – 9 , 13 , 16 , 18 , 19 , 21 – 25 , 27 – 30 , 32 – 38 ).…”

Mechanical and numerical investigations of biodegradable magnesium alloy screws for fracture treatment

“…Due to the aforementioned benefits, it is also used on other carpal bones fractures, 14 fractures in the elbow region 15,16 and patella fractures. 17 In 2013, the German company Syntellix introduced a magnesium alloy screw (CS model), declaring it fully self-resorbing and therefore a possible fix for the aforementioned complications.…”

“…Application of a Herbert screw is not limited to the scaphoid, though. Due to the aforementioned benefits, it is also used on other carpal bones fractures, 14 fractures in the elbow region 15,16 and patella fractures 17 …”