Anterior elbow approach and internal fixation for the treatment of capitulum humeri fractures / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical result of anterior elbow approach and internal fixation for the treatment of capitulum humeri fractures. Methods From January 1997 to December 2003,11 patients of 9 males and 2 females with capitulum humeri fractures were chosen anterorredial approaches of elbow. The fractures were terated with under direct vision and were fixed with screws. The left arms in 7, right in 4, the age of the group were from 14 to 18 years old, with the average of 15 years. 7 cases of them were treated with close reduction but failed. The operative time was from 3 days to 7 days after injury. They were fresh and close fractures. According to wangyicong's classification system all were TypeⅠ. Results All operations were successful, no nerves and blood vessels injury, the incisions were all healed by first intention. The X-ray films shows that the fractures were anatomic reduction. The healing time was 6 weeks in average and all patients were followed up with an average 3.5 years, no postoperative complications such asmyositis ossificans, post-traumatic arthritis, avascular necrosis of capitulum humeri. According to Cassebanm and the percentage of elbow joints pain was measured with patient visual pain index function score system 7 caese of excellent, 4 case of good. Conclusion Displace of capitulum-trochlea hemeri does not link with muscle and capsula articularis, blood carries supply. Without avascular necrosis probably occurs at far stage. The close manipulation of capitulum humeri fractures hardly succeeds. The treatment with accurate open reduction associated with strong fixation can decrease the rate of avascular necrosis in the capitulum humeri fractures. The capitulum humeri fractures are suitable for opening reduced direct vision and fixing with screws through anteroeedial approaches of the elbow. The patients were encouraged to proceed for active rehabilitation early such as the elbow flexion-extension. Its short-term clinical outcomes is more excellent.