Capitellar fractures are specific types of elbow fractures that involve the capitellum, a rounded eminence on the distal end of the humerus, which articulates with the head of the radius. These fractures are often classified as a type of supracondylar fracture and are most commonly seen in children and adolescents due to the vulnerability of their still-developing bones. The capitellum plays a crucial role in the proper functioning of the elbow joint, facilitating motion and weight-bearing. This type of fracture typically occurs as a result of a fall onto an outstretched hand, where the impact force travels through the upper extremity, leading to failure in the capitellar region. The mechanisms of injury often involve hyperextension or a direct blow to the elbow, and they may also be associated with radial head fractures, particularly in adults, where high-energy trauma, such as motor vehicle accidents or sports injuries, is implicated. Clinically, patients may present with significant pain, swelling, and limited range of motion in the elbow, as well as visible deformity in more severe cases. On examination, tenderness is usually localized over the lateral aspect of the elbow, with restricted movement in flexion and extension. Radiological investigations, primarily X-rays, are critical in identifying the fracture, and in some cases, advanced imaging such as CT scans may be recommended to evaluate the extent of the injury and to plan appropriate management. Treatment protocols may vary, but they often range from conservative management with immobilization in a splint or brace for non-displaced fractures to surgical intervention for displaced fractures. Surgical options may include open reduction and internal fixation, where plates and screws are used to stabilize the fracture fragments, ensuring proper alignment for optimal healing and function. Early diagnosis and appropriate treatment are crucial in preventing complications such as malunion, nonunion, or the development of conditions like post-traumatic arthritis, which can significantly impair elbow function and range of motion. Rehabilitation begins soon after the surgical fixation (if indicated), and it focuses on gentle range of motion exercises to restore flexibility, followed by strengthening exercises to regain function. The prognosis generally depends on the severity of the fracture, the age of the patient, and the timing and adequacy of treatment; however, with proper care, many patients can return to their pre-injury activities without significant long-term deficits. Understanding the nature of capitellar fractures, their causes, and the clinical approach to manage them is essential for healthcare providers to ensure optimal patient outcomes and to minimize complications associated with this common elbow injury.
