Apparent Capitellar Fractures

Isolated capitellar fractures are rare but are identified as such, even when they are more complex, because the displaced capitellar fracture is usually the most obvious and identifiable radiographic finding and because teaching has traditionally underemphasized the involvement of the trochlea in such fractures. The author prefers the term ‘apparent capitellar fractures’ and draws on his experience to explain why he favors three-dimensional CT for depicting fracture detail. This article discusses treatment options, emphasizing open reduction and internal fixation to restore the native elbow. Operative techniques, including extensile lateral exposure and olecranon osteotomy; fixation techniques; and elbow arthroplasty, are described. Complications, such as ulnar neuropathy and infection, are also covered.