PMC9091387_01
(a) Pre-operative clinical picture of the right elbow. (b) Pre-operative X-rays of the right elbow (anteroposterior and lateral view).
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F1
On radiographic examination, the right elbow was found to be anteriorly dislocated with medial epicondyle fracture and comminuted lateral condyle fracture (Fig. 1).
Pre-operative 3D computed tomography scan of the right elbow.
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F2
A computed tomography (CT) with 3D reconstruction (Fig. 2) confirmed an anterior dislocation of the right elbow joint with the associated distal humerus, lateral sagittal, partial articular, trans-trochlear multi-fragmentary, epiphyseal-metaphyseal lateral condyle fracture, and medial epicondyle fracture (AO/OTA Classification - 13-B1.3).
Intraoperative pictures - (a and b) lateral condyle fixation; (c and d) medial epicondyle fixation.
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F3
After the reduction of all major fragments, multiple Kirschner wires (K-wires) were used for provisional fixation (Fig. 3).
A schematic diagram illustrating the placement of multiple cantilever K-wires in (a) lateral and (b) anteroposterior view of the distal humerus.
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F4
Subarticular K-wires were inserted just below the articular cartilage in parallel cantilever pattern (Fig. 4) and along the para-articular curvature of the articular surface of capitellum and then the ends were coalesced and buried under a lateral pillar plate to provide a stable and rigid interface with the lateral column.
(a) Immediate post-operative X-rays (anteroposterior and lateral views); (b) post-operative 8 months X-rays (anteroposterior and lateral views).
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F5
The radiographic review at 8 months also showed good bony union (Fig. 5).
Clinical pictures at the post-operative period of 8 months.
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F6
The range of supination was 80  and pronation was at 5  (Fig. 6).