The Treatment of Fracture-separation of the Capitular Epiphysis.

It has long been recognised that displaced fractures of the capitular epiphysis in children are prone to non-union and late deformity unless accurate reduction is obtained. Good results have been reported from conservative treatment (Kini 1942, McLearie and Merson 1954), but it is generally accepted that to obtain the best results open reduction is necessary. Some form of internal fixation is also advisable to prevent the pull of the common extensor muscles redisplacing the fragment. Internal fixation may be by suture of the extensor origin to the periosteum of the proximal fragment (Badger 1954, Watson-Jones 1955), or by fixation with screws or wire (Jeffery 1955, 1957, 1958; Wilson 1955). The present review was undertaken to determine if there was, in fact, any difference in the result obtained by the use of either soft-tissue suture or metallic fixation.