Fixation of fracture capitellum humerus

Fracture of capitellum is a rare fracture of distal humerus mostly seen in young adult. At present time there are different method of treatment and fixation of capitellum are available and described in literature. In this article we present diagnosis and management of different types of capitellar fracture in rural medical college with available instruments and implants. Between 2007 to Sept 2015 eight patient of capitellum were treated in our hospital. There were five male age16 to 30 years and three female patient age 22years and 45 years. In two cases the fracture was missed by private hospital and managed there conservatively by above elbow POP cast for 6 and 8 weeks marked stiffness of elbow present in both cases. Six cases came directly to our hospital. In these eight cases six cases were type one (Hahn steinthal fracture), one was Mc kee type four type and one case was associated with fracture of lateral condyle. All cases were treated under general anaesthesia and tourniquet by open reduction through modified Kochers approach and internally fixed by 4mm partially threaded cancellous screws inserted from posterior part of lateral condyle avoiding the penetration of anterior articular surface. All the fractures united uneventfully except one with loss of 15 degree in flexion and extension. Radiologically no signs of AVN and arthritis were present in seven cases but mild arthritis was present in one case. Screws were removed after 12 to 18 months of surgery. We got good result by using modified Kochers approach and fixation by partially threaded cancellous screws. We use Mayo elbow performance score to evaluate the result of surgery which was excellent in seven cases and good in one case.