Type IV capitellum fractures in children.

BMJ Case Reports
Yvonne-Mary PapamerkouriouGeorge Christodoulou

Abstract

Capitellum fractures represent 1% of elbow fractures. A coronal shear fracture which involves the trochlea is classified as a type IV McKee fracture. The combination of its rarity in the paediatric population as well as its unique appearance on X-ray make diagnosis of this fracture a challenge. We present the case of a 14-year-old boy who sustained this fracture falling from his bike. It was diagnosed from the double arc sign on X-ray. In addition, a CT scan was obtained to aid preoperative planning. It was treated by open reduction and fixation with two headless compression screws. Follow-up at 6 months showed no avascular necrosis. The patient could achieve full extension, while flexion was reduced only by 5°. Final follow-up was conducted at 15 months. Anatomic reduction and stable internal fixation are essential for a good outcome in these uncommon paediatric fractures.

References

Jan 1, 1996·The Journal of Bone and Joint Surgery. American Volume·M D McKeeH B Bamberger
Dec 6, 2008·The Journal of the American Academy of Orthopaedic Surgeons·David E RuchelsmanKenneth A Egol
Oct 20, 2009·Indian Journal of Orthopaedics·Ss Suresh
Nov 4, 2009·Journal of Shoulder and Elbow Surgery·Neil AshwoodQuentin Fogg
Sep 18, 2012·Journal of Shoulder and Elbow Surgery·Mehmet Oguz DurakbasaMehmet Nurullah Ermis
Jun 1, 2014·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·T KurtulmusF Akpinar
May 30, 2017·International Journal of Surgery Case Reports·M FuadM Bakdach

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Citations

Jun 21, 2021·Journal of Orthopaedic Surgery and Research·Lingpeng JuXiangyang Qu

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