Pediatric Capitellar Fracture

 
  • rare in young children
  • average age = 14.7y/o

Capitellar Fx Clinical exaluation

  • pain after fall on outstretched arm
  • tenderness of lateral elbow, swelling
  • decreased ROM

Capitellar Fx Xray

  • A/P, lateral and oblique views of elbow, consider getting comparision views of uninjured extremity
  • soft tissue swelling, anterior and posterior fat pad signs often evident even if fx is not well seen
  • if fx is suspected, but no seen on plain films consider arthrogram, MRI or CT

Capitellar Fx Classification / Treatment

  • Non-dsiplaced fx = immobilization (Salter RB, JBJS AM 1963;45:587-622)
  • Osteochondral fx = excision (Grantham SA, CORR 1981:161:262-9)
  • Displaced fx, sleeve fx = open reduction percutaneous pinning (Letts M J Pediatr Orthop 1997;17:315-20)