Reconstruction of Capitellar Defect using Freeze-dried Cadaveric Allograft – A Case Report

INTRODUCTION: Elbow instability following non-reconstructible capitellum fracture could be a source of severe pain and discomfort. There are limited treatment options to address this which include either a total elbow replacement or radiocapitellar replacement. However, these can be challenging in elderly patient with low bone stock. We present such a case in a patient who was managed with reconstruction of capitellum using freeze-dried cadaveric allograft. CASE PRESENTATION: A 64-year-old Caucasian female sustained a comminuted capitellar fracture. She was taken to theater for fixation of fracture, however, in view of severe communition, it was found to be non-reconstructible and hence had to be excised. She continued to have symptoms of pain and instability. She was treated with freeze-dried allograft from cadaveric bone to reconstruct the capitellum. Five months following surgery, she had no pain and achieved functional range of motion. At her final follow-up at 2 years, she remained asymptomatic and had full range of motion at elbow joint. CONCLUSION: Capitellum reconstruction using allograft showed excellent result in short term in our patient. Ours is the first case report of using an allograft to reconstruct capitellum following severely comminuted, non-reconstructible capitellum fracture following trauma in elderly patient with osteoporotic bone.