Materials & Methods:Four patients were treated in our hospital from 2018 to 2019, for Type IV capitellum fractures. The mechanism of injury was a fall on the out stretched hand in three patients while the fourth patient was involved in a motor cycle accident. The fractures were equally distributed on either elbows, two on each side. The three males patients were aged between 18 to 30 years while the lone female was 40 years of age. All patients were operated in the supine position under general anaesthesia, using a tourniquet and with fluoroscopic guidance. Surgery was performed through an extended lateral Kocher’s approach. Definitive fixation in two patients was by using 2.7mm Herbert screws alone while in one with a lateral condyle humerus fracture, fixation was supplemented using plate and screws. K-wire fixation was used for one patient.

Results: 2 patient attained a score of excellent in the Mayo Elbow Performance Score evaluation while 1 patient each had a good and a fair score. There was no evidence of arthritis, avascular necrosis or heterotopic ossification till 1 year of follow-up.

Conclusion: Flawless reduction and fixation of the fragment with appropriate postoperative rehabilitation protocol are crucial to achieving optimal results.