Coronal shear fractures of the distal humerus: the capitellum and trochlea.

Fractures of the capitellum and trochlea are uncommon and multiple options have been advocated for the treatment of this injury. A single management technique has not emerged as the superior technique, and a complement of interventions is necessary to manage the continuum of injuries that can be observed. In general, open reduction and internal fixation is advocated for healthy and active patients with satisfactory bone quality to allow for the insertion of stable fixation. In the geriatric population, total elbow arthroplasty may emerge as the treatment of choice particularly for the more comminuted fracture patterns. Postoperative rehabilitation is important and is guided by fracture stability, ligament integrity, and the ability of the patient to cooperate with the treatment protocol. Gratifying results can be achieved in most patients with even the most complex injuries.