Extensile Posterolateral Novel Approach Through the Anconeus Muscle for an Atypical Coronal Shear Fracture of the Capitellum with Associated Lateral Epicondyle and Olecranon Fractures: A Case Report

Abstract: A 70-year-old female with a history of hypertension presented with a complex elbow injury following a fall. Imaging revealed fractures of the capitellum, lateral epicondyle, and olecranon. The fractures were managed using an extensile posterolateral approach through the anconeus muscle, achieving anatomical reduction and satisfactory functional outcomes 110° of flexion and full pronation/supination and Mayo Elbow Performance Score (MEPS) indicated an excellent outcome. This approach preserved the extensor origin and facilitated access for fixation, suggesting its potential as an alternative for managing such rare injuries. Plain Language Summary: This case report describes a rare and complex elbow injury involving fractures of the capitellum, lateral epicondyle, and olecranon in a 70-year-old woman. A surgical approach through the anconeus muscle was used to repair the damage while preserving important structures. The patient recovered well and regained good arm function. This approach could be a useful option for similar injuries in the future. Keywords: coronal shear fracture, capitellum, extensile posterolateral approach, elbow fracture, orthopedic surgery