Capitellar Fracture
Uncommon fracture which is difficult to diagnose if fracture fragment is small
Type I
- Hans Steinthal fracture
- fracture of the capitellum in the coronal plane
- involves large part of the osseous portion of capitulum
- fracture hinges anteriorly between radial head and radial fossa producing a block to flexion
Management
If closed reduction is obtained, then reduction is usually stable with elbow flexion
Open reduction
A. Posterolateral / Kocher approach
- between aconeus and ECU
B. Lateral approach
- between EDC and ECRB
- may place PIN at increased risk
One or two headless compression screws
- front to back
- buried
Type II
- Kocher Lorenz fracture
- affects primarily articular cartilage and very little underlying bone
- these usually cause few subsequent joint problems
Management
- healing potential is minimal & excision is recommended