Capitellum fracture: Difference between revisions

 
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==Background==
==Background==
[[File:Capitulumhumeri.png|thumb|Capitellum of humerus.]]
*Fracture of distal humerus at capitellum
*Fracture of distal humerus at capitellum
*Rare, occurs in approx 1% of elbow fractures
*Rare, occurs in approximately 1% of elbow fractures
*Mechanism: FOOSH
*Often require surgery, with good prognosis
*Often require surgery, with good prognosis
{{Proximal arm fracture DDX}}


==Clinical Features==
==Clinical Features==
*Mechanism: FOOSH
*Pain, swelling, may have block to flexion / extension
*Pain, swelling, may have block to flexion / extension


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{{Elbow DDX}}
{{Elbow DDX}}


==Diagnosis==
==Evaluation==
*[[Elbow X-ray]]
*[[Elbow X-ray]]
**Fractures are often subtle
**Fractures are often subtle
** Best seen on lateral XR
**Best seen on lateral XR
***Look for abnormal fat pad
***Look for abnormal fat pad
***Look for radiocapitellar line disruption
***Look for radiocapitellar line disruption
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==Management==
==Management==
{{General Fracture Management}}
===Immobilization===
*[[Long arm posterior splint]] for Operative / Non operative
*[[Long arm posterior splint]] for Operative / Non operative


===Non-operative management===
==Disposition==
* Less than 2mm of displacement
*Normally outpatient, unless concerning neurovascular injury, [[open fracture]], or coexisting injuries requiring admission


===Operative management===
===Specialty Outpatient Care===
* More than 2 mm of displacement
====Non-operative management====
* Capitellum with co-existing trochlea involvement
*Less than 2mm of displacement
* Comminuted fracture


==Disposition==
====Operative management====
*Normally outpatient, unless concerning neurovascular injury, [[open fracture]], or coexisting injuries requiring admission
*More than 2 mm of displacement
*Capitellum with co-existing trochlea involvement
*Comminuted fracture


==Potential Complications==
==Potential Complications==
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==References==
==References==
*Orthobullets
*[http://www.orthobullets.com/trauma/1023/capitellum-fractures Orthobullets]
[[Category:Orthopedics]]
[[Category:Orthopedics]]

Latest revision as of 21:58, 22 June 2020

Background

Capitellum of humerus.
  • Fracture of distal humerus at capitellum
  • Rare, occurs in approximately 1% of elbow fractures
  • Often require surgery, with good prognosis

Humerus Fracture Types

Humeral anatomy

Clinical Features

  • Mechanism: FOOSH
  • Pain, swelling, may have block to flexion / extension

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

Evaluation

  • Elbow X-ray
    • Fractures are often subtle
    • Best seen on lateral XR
      • Look for abnormal fat pad
      • Look for radiocapitellar line disruption
        • If possible, lateral elbow is shot at 45 degrees to pick up subtle fractures
  • Consider CT to further identify fracture / operative planning

Management

General Fracture Management

Immobilization

Disposition

  • Normally outpatient, unless concerning neurovascular injury, open fracture, or coexisting injuries requiring admission

Specialty Outpatient Care

Non-operative management

  • Less than 2mm of displacement

Operative management

  • More than 2 mm of displacement
  • Capitellum with co-existing trochlea involvement
  • Comminuted fracture

Potential Complications

  • Elbow contracture
  • Nonunion
  • AVN
  • Ulnar nerve injury

See Also

References