Humeral Capitellar Fractures Fixation with Herbert Screws

Background: Capitellar fractures are quite rare injury and often missed primarily. Different treatment options are available but optimal elbow functions can only be achieved by rigid anatomical fixation. Headless screw system is current trend of fixation. Aim: To asses functional outcome of Herbert screw fixation in capitellar fractures. Methods: Fifteen patients with displaced capitellar fractures were studied between October 2014 & May 2018 at Orthopedics II, Jinnah Hospital Lahore. All were operated through lateral approach. Herbert screw fixation was done after anatomical reduction. All patients were followed up for an average of 22.53 months. Clinical and functional assessment were measured by Mayo Elbow Performance Index (MEPI) & radiologically. Results: All patients were evaluated according to MEPI scoring over 100 points. 66.66% (10) patients got excellent outcome with mean MEPI score of 89.The average arc of ulnohumeral joint was 125 degree with supination/pronation 170 degree. Radiologically, average capitellar fracture healing time was 9 weeks with none of case having AVN. 4 cases (26.66%) developed heterotrophic ossification. Osteoarthritis was noted in two cases (13.33%). Conclusion: Herbert screws fixation of capitellar fractures has good functional results because of adequate compression, rigid fixation and early rehabilitation.