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Objective: To study the operation points of manual reduction for treatment of capitellum fractures of type I and analyze the characteristics of fixation with paper splint., Methods: From April 2000 to February 2008, 27 cases with capitellum fractures of type I were treated by manual reduction of 90 degrees bending elbow and external fixation with paper splint, included 23 males and 4 females aged from 5 to 14 years old (means 8.9 years) with the course from 1 to 23 hours (averaged 5.4 hours). Before treatment all the wounded elbows were swollen and malfunctioned, the X-ray film showed that the fracture fragments of capitellum were separated and upside down displaced in varying degrees. During reduction, the correct restoration point was found and the reduction was correct, continuous and steady, and coordinated the passive movement of forearm and elbow joint, and the 90 degrees bending elbow was fixed by paper splint. All the patients were assessed according to JOA elbow joint function assessment method., Results: All 27 patients were followed-up for from 6 months to 2 years (averaged 17 months). All the elbow joints were painless, the movement and functions were normal, the elbow joints were stable. After reduction, no complication was found. There were 25 cases with the fracture site reaches or nearly reaches healing of anatomical counterparts, only 2 cases with slight cubitus valgus deformity. According to JOA score 25 cases gained 100 scores and 2 cases gained 97 scores., Conclusion: This method has advantage of strong stability, high success rate, firm and easy fixation, without pressure sore and necrosis.

Based on systematic three-dimensional (3-D), large strain FE limit analyses using elastic- perfectly plastic materials, this paper quantifies the effect of local wall thinning on plastic behavior and TES (twice-elastic-slope) plastic loads for 90° elbows under in-plane bending. The thinning geometry is assumed to be rectangular rather than circular, but the nonlinear geometry effect is fully considered. Results from systematic analyses lead to simple approximations for TES plastic loads, covering a wide range of elbow and thinning geometries. Although the proposed approximations are developed for the case when wall thinning locates in the center of the elbow, it is also shown that they can be equally applied to the case when thinning exists anywhere within the elbow. Brief discussion is made on application of the proposed approximations to estimate maximum load-carrying capacities of elbows with local wall thinning. [ABSTRACT FROM AUTHOR]