Closed reduction of coronal fractures of the capitellum.

Closed reductions of displaced coronal fractures of the capitellum were successfully obtained for nine patients. The method involves spontaneous reduction by allowing the elbow to fully extend under anesthesia and then gradually flexing the elbow while distracting the elbow joint. Distraction allows the radial head to capture the capitellar fragment in the joint rather than push it proximally. The elbow is immobilized at 90 degrees for 3 weeks. Gentle active motion is then started. Closed reduction is often or usually obtained, but open reduction and internal fixation are performed in those cases in which a closed reduction cannot be obtained.