Diagnosis

Partial articular, frontal/coronal fracture 

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1. Capitellum fracture 
2. Trochlea fracture 
3. Capitellum and trochlea fracture 

1. Capitellum fracture 

Capitellum fracture

This fracture type is classified by the AO/OTA as 13B3.1.

Take care when approaching an apparently simple capitellar fracture. These are often complex. The majority extend into the lateral trochlea and should not be considered for nonoperative treatment.

Many fractures also involve a fracture of the lateral epicondyle and impaction of posterior aspect of the lateral column, or the posterior trochlea.

Computed tomography with 3D reconstruction helps to identify the fracture anatomy, and facilitates planning.

Capitellum fracture

2. Trochlea fracture 

Trochlea fracture

This fracture type is classified by the AO/OTA as 13B3.2.

Trochlear fractures are difficult to see on radiographs. Computed tomography - with 3D reconstruction - is particularly useful for understanding the fracture anatomy.
There is often complex articular comminution.

Trochlea fracture

3. Capitellum and trochlea fracture 

Capitellum and trochlea fracture

This fracture type is classified by the AO/OTA as 13B3.3.

These fractures are often associated with impaction of the posterior part of the lateral column, and/or the posterior trochlea.

Most apparently isolated capitellar fractures are more complex than they initially appear.
Computed tomography - particularly 3D CT - can help to define the fracture anatomy and facilitate planning of the surgery.

Capitellum and trochlea fracture