Capitellum Fracture: Surgical Exposure and Fixation Strategies

Abstract

Fractures of the capitellum are uncommon, often accompanied by radial head or lateral collateral ligament injuries, and typically treated operatively. Operative fixation is often technically challenging due to limited surgical windows, limited bone stock for fixation, its articular nature, and fracture extension into the trochlea or condyles. The goal of treatment is stable internal fixation to permit an early range of motion. Aside from open reduction internal fixation (ORIF), alternative treatment options include fragment excision and arthroscopic assisted reduction and fixation. Here we detail our preferred approach to treat capitellum fractures, including, preoperative planning, surgical anatomy, surgical setup and technique utilizing a posterior utility incision and olecranon osteotomy, postoperative care, and avoidance of potential complications.