Fractures of the capitellum.

Fractures of the capitellum account for less than 1% of all elbow fractures. Because they may be difficult to visualize on plain radiographs, the clinician must have a high index of suspicion for their diagnosis. Anatomic alignment of these fractures is imperative; slight residual displacement may result in significant loss of elbow motion. Surgical management is described with open reduction internal fixation using variable pitch headless screws, precontoured plates, or bioabsorbable pins. The optimal method of fixation depends on the fracture pattern and degree of comminution. If the fracture fragments are too small for stable fixation, excision of the fragments is recommended. Osteonecrosis, as well as, end-stage arthrosis requiring total elbow arthroplasty, has been reported as a rare, but potential, complication.