Introduction: Capitellar fractures are uncommon intra-articular injuries often misdiagnosed initially. Neglected cases typically progress to malunion, causing substantial elbow stiffness, persistent pain, and functional impairment. This series details three patients with neglected Type 2 capitellar malunions, demonstrating surgical intervention via the Kaplan approach effectively restores elbow motion, alleviates pain, and enables return to daily activities.
Case Presentation: Three patients (two females, one male) aged 25-34 years presented with elbow stiffness and chronic pain months after initial trauma. All had untreated or misdiagnosed fractures. CT imaging confirmed Type 2 capitellar malunion in all cases. Surgical management through the Kaplan approach provided excellent visualization for anatomical reduction. Stable fixation was achieved using headless or compression screws based on fracture characteristics.
Clinical Discussion: The surgical approach enabled early postoperative mobilization. All patients initiated active range-of-motion exercises within the first week. This rehabilitation protocol prevented recurrent stiffness and promoted optimal recovery. At final follow-up, all patients that achieved near-complete functional elbow motion. All participants returned to pre-injury activity levels without residual pain or functional limitations. Follow-up evaluations confirmed a maintained recovery without complications.
Conclusion: Neglected Type 2 capitellar fractures present considerable therapeutic challenges, typically culminating in painful malunion and severe elbow dysfunction. However, this case series conclusively demonstrates that timely and precise surgical intervention utilizing the Kaplan approach for anatomical reduction and stable internal fixation, when integrated with a structured and aggressive early rehabilitation program, can yield excellent functional restoration and highly satisfactory patient-reported outcomes, establishing it as a reliable and effective treatment strategy.