The mechanism is mostly axial compression on the elbow with some valgus stress. This fracture can also be seen in combination with atypical elbow dislocations. In this situation it is important to be aware of the possibility of medial ligament avulsion.
As this is mostly compression trauma, growth arrest might occur.
If the fragment is markedly displaced, avascular necrosis of the capitellum might occur.
For an open reduction of this fracture type, it is recommended to perform a posterolateral skin incision. This allows preparation of the anterior aspect for capsulotomy and visualization of the joint surface for anatomical reduction.
Timing of treatment
There is no indication for immediate surgery. This surgery can be planned in the regular clinical program over the next few days.
The following points influence the timing of the treatment:
- Availability of surgical resources, including an experienced surgeon
- The patient should be treated on a routine operating list, in a specialist unit. In the meantime, plaster splint immobilization of the elbow joint is recommended for pain management
- Associated elbow dislocation