Coronal shear fractures of distal humerus: Diagnostic and treatment protocols

Figure 4 Type 4 capitello-trochlear fracture with medial epicondyle and olecranon chip fracture in adolescnt. It was managed by articular reconstruction by lateral approach. A: Fourteen-year-old male presented with left elbow type 4 capitellum fracture after road traffic accident. Associated injuries are medial epicondyle and chip fracture olecranon. Anteroposterior view; B: Lateral view showing double arc sign; C: Extensile lateral approach was done. Intraoperative picture showing fractured fragment; D: Major capitellar fragment debrided on table; E: On table reconstruction of the articular fragment was done by 2.7 mm screw; F: Final fixation was done by two headless screws; G: Follow-up AP view; H: Lateral view; I and J: Rotations at follow-up; K: Flexion at follow-up. The patient is having excellent Mayo Elbow Performance Score; L: Extension. The lag is attributed to type of fracture and the approach.