Background: Capitellar fractures are rare intra-articular injuries of the distal humerus, accounting for nearly 1% of elbow fractures (1). Timely fixation is recommended to restore joint congruity and allow early mobilization (2). In many settings, especially in developing countries, presentation may be delayed due to missed diagnosis or late referral (3). The management of such late cases remains challenging.
Introduction: This study evaluates the functional and radiological results of late-presenting capitellar fractures treated surgically by open reduction and Herbert screw fixation.
Results: Among 35 adult patients, all fractures united by 10-14 weeks. Functional outcomes by Mayo Elbow Performance Score (MEPS) were Excellent in 17 (49%), Good in 12 (34%), and Fair in 6 (17%). No patients had a poor outcome. Complications occurred in 6 cases (17%), including 5 with postoperative stiffness and 1 with degenerative arthritis.
Conclusion: Anatomic reduction with Herbert screw fixation in late-presenting capitellar fractures provides reliable union and favorable functional results, although stiffness remains a common complication.
Keywords: Capitellar fracture; elbow; fixation; Herbert screw; late presentation
http://medicalchannel.pk/wp-content/uploads/2025/12/Result-of-Open-Reduction-69-72.pdf