title: Closed reduction and early mobilization in fractures of the humeral capitellum.
abstract: Seven consecutive patients with an isolated fracture of the humeral capitellum were treated by a single surgeon at a Level II care facility according to a simple treatment algorithm. Closed reduction was attempted in all cases using a standard technique. After reduction, the arm was splinted at 90° of flexion and mobilized at 14 days. All patients completed a clinical and radiographic follow-up consisting of a radiographic evaluation of reduction, elbow range of motion, Disabilities of the Arm, Shoulder and Hand Questionnaire, and a subjective rating of patient satisfaction. None of the patients required conversion to open reduction internal fixation or excision. Disabilities of the Arm, Shoulder and Hand Questionnaire scores ranged from 6 to 13 points (out of 100; mean, 9). The mean flexion/extension arc of motion obtained was 126° with minimal loss of rotation. Patient satisfaction was rated as excellent in five patients and good in two. All fractures appeared united at the most recent clinical and radiographic review. Closed reduction and early mobilization appears to be a safe and effective method of treating displaced fractures of the humeral capitellum with clinical results comparable to that of open reduction internal fixation.
authors.affiliation: Division of Orthopaedic Surgery, University of Calgary, Calgary, Alberta, Canada. spuloski@ucalgary.ca
authors.forename: Shannon
authors.initials: S
authors.lastname: Puloski
authors.forename: Kyle
authors.initials: K
authors.lastname: Kemp
authors.forename: David
authors.initials: D
authors.lastname: Sheps
authors.forename: Kevin
authors.initials: K
authors.lastname: Hildebrand
authors.forename: John
authors.initials: J
authors.lastname: Donaghy
mesh_terms: D000293:Adolescent; D000328:Adult; D001510:Bed Rest; D004185:Disability Evaluation; D004434:Early Ambulation; D004550:Elbow / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods / Q000534:rehabilitation; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000503:physiopathology / Q000628:therapy*; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013165:Splints; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult; D000092464:Elbow Injuries