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Clinical Example: Capitellar fracture nonunion excision
| Click on each image
for a larger picture |
| Initial injury: supracondylar fracture
in a 9 year old: |
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| Open reduction and fixation: |
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| Five years later, he has limited motion
(E/F 35/100) and painful clicking with elbow flexion and extension. |
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| Plain films show humeral osteophytes
and posttraumatic changes of the capitellum and radial head. |
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| MRI shows an osteochondral sequestrum
of the anterior capitellum: |
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| Treatment options? Do nothing, Open
reduction and bone graft, sequestrum excision or radial head excision.
In this case, at surgery, the loose articular fragment was too thin to
allow reliable fixation, and was simply excised. |
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| Postoperatively, pain is improved,
although some clicking persists. Range of motion is marginally improved.
Radial head excision remains an option if he has painful problems later. |
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Hand
assh.org
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Resource
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Period.
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