Accepted for publication
An article titled "Capitellar Fractures: Is ORIF Necessary?" has been accepted by the Journal of Orthopaedic Trauma. The authors are K. Cutbush, S. Andrews, N. Siddiqui, L. M. Brown and M. Ross.
What it concerns
The capitellum is the rounded part of the lower end of the humerus that articulates with the radius at the elbow. Fractures of it are relatively uncommon and usually follow a fall onto an outstretched hand, which drives the radial head up into the capitellum.
The conventional approach to a displaced capitellar fracture is open reduction and internal fixation (ORIF), meaning the fracture is exposed surgically and held with screws. The question the title poses is whether that is always necessary.
What it reports
The paper covers the non-operative management of these fractures, where the fracture is reduced without opening the elbow. Published series report good results with closed reduction in appropriately selected cases, avoiding the need for open surgery. Individual results vary, and which fractures are suitable depends on the pattern and displacement of the fracture.
What acceptance for publication means
Acceptance follows peer review. A manuscript sent to a journal of this kind is read first by an editor and then passed to independent reviewers, usually surgeons or researchers working in the same area, who assess whether the method is sound, whether the data support what is claimed, and whether the work adds anything to what is already published.
Their reports go back to the authors, who revise the paper or answer the criticisms, and the cycle may repeat more than once. Only then is a paper accepted, and a good deal of what is submitted is declined. The process is slow, but it is the main reason the published literature can be used as a basis for clinical decisions rather than treated as one surgeon's opinion. Posing a question of this sort in a journal title is itself part of how accepted practice gets examined.
Note
This paper concerns the elbow rather than the shoulder, and reflects work on upper limb trauma more broadly.
Related information
- Our shoulder injuries page
- Our publications page
- Our post on proximal humeral fractures