Curative effect of open reduction and internal fixation for capitellum and trochlea fractures

• DOI: 10.3760/cma.j.issn.1001-8050.2017.06.008
• Publication Date: 2017-06-15
• Authors: Liu Yang; Dong Wang; Xieyuan Jiang; Maoqi Gong
• Keywords: Avascular Necrosis; Elbow pain

Objective To observe the curative effect of open reduction and internal fixation for capitellum trochlea fractures.

Methods A retrospective case series study was performed on 14 patients with fractures without involving lateral column treated by from April 2008 to August 2016. There were four males 10 females, aged 24 62 years (mean, 41.4 years). Dubberley classification type ⅠA in patients, ⅠB three, ⅡA two, ⅡB one, ⅢA ⅢB two. Three combined ipsilateral capitulum radius fractures, one patient ulna olecranon fracture. Visual analogue scale (VAS) elbow pain, activity Mayo performance score (MEPS) evaluated. Postoperative complications also observed.

Results All followed up 24-55 months 27.2 months). Fracture healed after (21.3±2.1)weeks. VAS (2.1±1.9) points at postoperatively, painless three mild pain seven moderate four. Elbow flexion extension angle (93.4±15.2)°, (114.3±11.1)°, (33.6±20.7)°, forearm front rotation (75.2±12.5)°, back (83.2±8.2)°. No had instability, ischemic necrosis or loosening. MEPS (74.2±17.8)points, including excellent results 3 cases, good 8, fair 2 poor 1. One developed ulnar nerve symptom alleviated months. Five cases (two ⅢA, ⅢB, ⅡA, ⅡB) a small amount heterotopic ossification 6 month operation, but good. fracture process 1 further large displaced around showed 30° operation that significantly limited compared contralateral side.

Conclusion Open can improve reduce incidence postoperative complication.

Key words: Humeral fractures; Trochlear nerve; Fracture fixation,