Posterolateral Shear Fracture of the Capitellum Associated with Elbow Dislocation in Adolescent: A Case Report

Abstract

Background: Posterolateral shear fractures of the capitellum are extremely rare in adolescents and are typically associated with elbow dislocations. The fracture fragment, involving the posterolateral part of the capitellum and mostly cartilaginous, makes diagnosis difficult. This report describes the case of an adolescent patient with a posterolateral shear fracture of the capitellum associated with elbow dislocation. Case presentation: A 13-year-old male presented with a left elbow injury following a fall, resulting in a posterolateral dislocation and associated fracture. After successful reduction, imaging confirmed a type I Hahn-Steinthal posterolateral shear capitellar fracture. Surgical treatment involved open reduction and internal fixation using 3 Kirschner wires (K-wires), with subsequent removal at 4 weeks postoperatively. At the 6-month follow-up, there were no signs of complications, and the patient had achieved a full range of motion. Conclusion: Early and accurate diagnosis is crucial in managing pediatric capitellum fractures, which can be distinct in children and adolescents. Selecting a treatment approach that restores articular congruity and joint stability while avoiding intraarticular fragments is paramount. Advanced imaging modalities, such as cross-sectional imaging, are crucial in determining the fracture pattern and guiding treatment decisions.