Displaced supracondylar fractures of the paediatric elbow are a serious, but well described injury. Although complications are common, avascular necrosis (AVN) of the capitellum has not been described or reported before. We describe a case with this complication. A review of the relevant literature is also presented A three-year-old boy presented to our emergency department with a painful swollen left elbow after a fall. X-ray done in Accident and Emergency, reveal, a displaced, extension type, supracondylar fracture (Gartland Grade III1). An open reduction (medial approach) was done and the fracture reduced and stabilised with two crossed K wires. The fracture healed in an excellent position. However, at the three-month follow up, the elbow remained stiff with flexion from only 20 to 90 degrees and with very little supination. Eight months after the injury an arthrogram was undertaken which confirmed diagnosis of avascular necrosis of capitellum. No specific treatment for AVN given. Check radiographs showed healing of capitellum with no functional limitations.
