ORIF of Capitellar Fractures with Headless Screws

Kenneth A. Egol, MD and David E. Ruchelsman, MD

As the complex nature of capitellar fractures has become better appreciated treatment options have evolved from closed reduction and immobilization and fragment excision to a preference for open reduction and internal fixation in order to achieve a stable anatomic reduction, to restore articular congruity, and to initiate early elbow range of motion. Extensile surgical exposures and headless cannulated variable-pitch screws are used to address more complex fracture patterns, which may be more common than previously thought. These injuries are characterized by metaphyseal comminution and ipsilateral radial head fracture, and they often require supplemental fixation. Studies on the outcomes of open reduction and internal fixation of capitellar fractures and associated injuries to the trochlea, radial head, and the lateral collateral ligamentous complex are limited, but they have demonstrated satisfactory functional results in the majority of patients when the injury is limited to the radiocapitellar compartment. Kenneth A. Egol, MD, et.al. have utilized a uniform surgical approach for capitellartrochlear fractures consisting of an extensile lateral exposure, articular fixation with buried cannulated variable-pitch headless compression screws, and simultaneous repair of associated osseous and ligamentous injuries. This video supplement to the JBJS scientific and surgical technique articles demonstrates this surgical approach.

Material Covered

• Indications
• Contraindications
• Surgical Technique
• Pitfalls

Specifications

• Total Run Time: 11:36 minutes
• Catalog Number: 2524
• VJO Publication Date: March, 2010