WHICH FACTORS CAN DEFINE THE PROGNOSIS OF ARTICULAR FRACTURES OF THE CAPITELLUM AND TROCHLEA?

Abstract

ABSTRACT Introduction: Articular fractures of the distal humerus involving the capitellum and trochlea (AO 13B3) are complex and challenging to manage without consensus in the literature on the most appropriate management. Objective: Evaluate radiographic features and treatment-related factors that may be positively or negatively correlated with the outcome of these fractures. Methods: Sixteen adult patients who underwent surgery between 2007 and 2024 with at least one year of follow-up were analyzed retrospectively. Radiographic characteristics, postoperative range of motion, and complications were evaluated. Statistical analysis used Odds Ratio (OR) and Fisher's Exact Test. Results: Elbow stiffness occurred in 56% of patients, 83% of which were in cases with posterior wall involvement (OR=7.5; p=0.08). Preoperative immobilization for more than seven days was associated with range of motion impairment (60%, OR=3; p=0.58) and ulnar nerve neuropathy (30%, OR=6; p=0.09). All cases of ulnar neuropathy occurred in women with prolonged immobilization (OR=8.08; p=0.09). Conclusion: Posterior wall integrity is a relevant prognostic factor for the final range of motion. The propensity for ulnar neuropathy in women and those with prolonged immobilization, although without statistical significance, suggests the need for larger samples. Level of Evidence II; Retrospective study.