Functional and radiological outcome of capitellum fracture fixation with headless screws through lateral approach to elbow, a prospective observational study

Introduction: Capitellum fractures are rare injuries contributing only 1% of all elbow fractures. Being such a rare injury, there is a lack of consensus with regard to the treatment recommendations. This study aims to evaluate the functional outcome of capitellum fractures treated by open reduction and internal fixation (ORIF) with headless screws through a lateral approach. Materials and Methods: The study design was a prospective observational study conducted on 61 patients who were undergoing ORIF through a lateral approach to the elbow, between January 2023 and August 2025, at a tertiary care level 1 trauma center. The Oxford elbow score (OES) was recorded post-surgery, starting at 2 weeks and then at 2-monthly intervals. Results: The mean OES at 6 months was 32.6 ± 7.3 (18-46). Mean pronation-supination arc was 86.9 ± 20.2 (range 40-110°). Mean flexion-extension arc was 131.1 ± 2.9° (range 110-150°, standard deviation 11.5), with a 95% confidence interval of 128.2-134.0°. Our results suggest that ORIF is a safe and effective treatment option for a stable, pain-free elbow with a good range of motion. There was no evidence of avascular necrosis or arthritic changes. The mean duration of follow-up was 15.8 ± 3.2 months (range: 12-27 months). Conclusion: Headless compression screw fixation via a lateral elbow approach yielded stable fixation with excellent functional outcome for capitellum fractures in our study.