Capitellum Fracture Fragment Excision: a Case Series

HSS Journal Online First Article

Matthew R. Garner, MD
Hospital for Special Surgery, New York, NY

Patrick C. Schottel, MD
The University of Texas-Houston, Houston, TX

Aaron Daluiski, MD
Aaron Daluiski, MD

Associate Attending Orthopedic Surgeon, Hospital for Special Surgery
Associate Professor of Clinical Orthopaedic Surgery, Weill Cornell Medical College
Associate Attending Orthopedic Surgeon, NewYork-Presbyterian Hospital
Chief of Hand Service, NewYork-Presbyterian Hospital

Robert N. Hotchkiss, MD
Robert N. Hotchkiss, MD
Medical Director of Clinical Research, Hospital for Special Surgery
Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor of Surgery (Orthopaedics), Weill Cornell Medical College
Dean G. Lorich, MD
Dean G. Lorich, MD
Associate Director of Orthopaedic Trauma Service, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College


Fractures of the capitellum are rare injuries, and few studies have reported the results of fragment excision.

The purpose of this study was to determine range of motion and short-term clinical outcomes for patients treated with capitellum excision.

A retrospective review was performed to identify all patients with an isolated capitellum fracture who underwent excision as definitive treatment at our institutions. Mechanism of injury, associated elbow injuries, type of capitellum fracture, complications, and postoperative outcomes including final elbow range of motion (ROM), elbow instability, and Disabilities of the Arm, Shoulder and Hand (DASH) score were recorded.

Four patients met the inclusion and exclusion criteria of this study. All patients were female with an average age of 69 years (range 42–85). Based on the Bryan and Morrey classification system, three (75%) fractures were classified as type I and one (25%) fracture as type III. The average clinical follow-up was 11 months. Final examination demonstrated a mean elbow range of motion from 14° (range 0–30) of extension to 143° (range 130–160) of flexion. All patients had full forearm rotation, and there was no clinical evidence of elbow instability. The average DASH score was 18.3 (12.5–24.2) at final follow-up.

Excision of the capitellum, much like excision of the radial head, results in acceptable short-term outcome scores and elbow range of motion in patients with fractures that are not amenable to open reduction and internal fixation.

This Online First article was published online on SpringerLink in August 2015.
View the full article at

About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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