Failed Fixation of Capitellum Fractures

Failure of capitellum fixation is rare. The capitellum when fixed is susceptible to significant shear forces due to its anterior centre of rotation, particularly when loading the elbow in extension. Fixation should aim to best resist these forces, commonly attained through headless compression screws orthogonal to the fracture plane. Rehabilitation should be guarded, and whilst range of movement should be instigated early to regain range of motion, load bearing should be gradually reintroduced. Revision fixation should concentrate on achieving an anatomic reduction, and compression orthogonal to the fracture plane.