Surgical outcomes of coronal shear fractures of the capitellum and trochlea: a retrospective study of Dubberley classification-guided treatment

肱骨小头和滑车冠状剪切骨折的手术疗效:Dubberley 分类指导治疗的回顾性研究

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Abstract

OBJECTIVES: To investigate the surgical outcomes of coronal shear fractures of the capitellum and trochlea (CSFCT) guided by the Dubberley classification. METHODS: A retrospective analysis was conducted on patients with CSFCT between January 2015 and December 2023. Demographic information, surgical details, functional recovery outcomes, and postoperative complications were recorded and compared across fracture subgroup. RESULTS: 39 patients were included (mean age: 44.3 ± 15.5 years) with a mean follow-up of 38.2 ± 12.0 months. All patients underwent surgery via an extended lateral approach using various hardware. Postoperatively, the mean extension deficit was - 0.9°, mean flexion was 126.4°, and mean flexion-extension arc was 125.4°. The mean Mayo Elbow Performance Scores (MEPS) was 87.9 (66.7 % excellent, 30.8 % good, 2.5 % fair). Dubberley type 2 and A fractures had higher MEPS than type 3 and B, respectively (both p<0.01). Postoperative complications included two elbow stiffness, two implant prominence, and one avascular necrosis case. CONCLUSIONS: Under the guidance of the Dubberley classification, surgical treatment for patients with CSFCT has achieved greater efficacy, favorable outcomes, and low complication rates.

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