Surgical treatment of fractures of the capitellum

Five cases with fractures of the capitellum [Hahn-Steinthal type] were collected between 1988 and 1993 and treated in Kasr El -Aini Hospital, Cairo and Derriford Hospital, Plymouth. Four cases were treated with open reduction and internal fixation and in one case fracture was comminuted and beyond fixation and the comminuted fragment was excised. During follow-up period [6-24 months], the four cases treated with open reduction and interion regained a good range of movements of the involved elbow and were found to be free of pain and had a stable elbow. The case treated with exision of the comminuted capitellum fragment regained a good range of movementes but was complining of moderate pain during the first 30 degrees of flexion of the involved elbow and some valgus intability. So open reduction and internal fixation of fractures of the capitellum is a better method of treatment than excision if applicable

Operative treatment of displaced taller neck fractures

Thirteen cases of displaced talar neck fractures were treated by open reduction and internal fixation. All cases were managed within 12 hours after injury. The medical approach was used, 6 cases had associated fracture of the medial maleolus. In 3 cases osteotomy of the medial maleolus was performed. The fracture was fixed by 4 mm cancellous screws perpendicular to the fracture line. Results were evaluated by a standard rating system. Prompt open reduction and internal fixation, maleollar osteotomy when needed, and protected weight bearing are recommended in the management of these cases