Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Medical Imaging
  4. Volume 20, Issue 1
  5. Article
Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
file format pdf download PDF
side by side viewer icon HTML

Abstract

Background

Capitellar injury (CI) includes capitellar cartilage injury (CCI) and capitellar fracture (CF). A comprehensive classification of CI concurrent with radial head fracture (RHF) that can guide surgical strategy is lacking in the literature. Therefore, this study aimed to introduce a comprehensive classification of CI concurrent with RHF and investigate its value.

Methods

A total of 35 patients with CI concurrent with RHF confirmed by surgical exploration were retrospectively analyzed, including males in 19 cases and females in 16 cases. RHF was classified according to the Mason classification, and CI was classified into six types, including 3 types of CCI and CF, each based on the site and degrees of injuries (comprehensive classification method proposed in this study). The classification results were analyzed. Two radiologists were selected to independently classify the CI, and the inter- and intra-observer agreements were analyzed with kappa statistics.

Results

Mason Type I, II, III, and IV RHF accounted for 14.3%, 48.6%, 37.1%, and 0% of cases, respectively. Type I, II, III, IV, V, and VI CIs accounted for 22.9%, 34.3%, 25.7%, 11.4%, 2.9%, and 2.9% of cases, respectively. There was no obvious relationship between the CI and RHF types ( > 0.05). All Type I CIs underwent removal, 9 Type II CIs underwent microfracture repair, and 3 Type II CIs underwent removal. All Type III CIs underwent fixation, one Type IV CI underwent removal, and 3 Type IV CIs underwent fixation, one Type V CI underwent fixation, and one Type VI CI underwent arthroplasty. The inter- and intra-observer kappa coefficients were 0.830 ~ 0.905 and 0.805 ~ 0.892, respectively. At 12 months postoperatively, the elbow function evaluated by MEPS was 91, with an excellent and good rate of 97%.

Conclusion

Different types of CI differ not only in pathology but also in treatment methods. The CI comprehensive classification put forth in this paper for the first time reflects different types of pathology well, with high consistency and repeatability, and can guide the selection of surgical methods, leading to satisfactory postoperative results.

© 2024 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Loading

Article metrics loading...

/content/journals/cmir/10.2174/0115734056304073240625100529
2024-01-01
2025-05-13

  • From This Site

    /content/journals/cmir/10.2174/0115734056304073240625100529
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
The full text of this item is not currently available.

References

  1. YoonA. AthwalG.S. FaberK.J. KingG.J.W. Radial head fractures.J. Hand Surg. Am.201237122626263410.1016/j.jhsa.2012.10.00123174078
     [Google Scholar]
  2. RenD. XingD.M. FengW. WuF. ChenY. ZhaoZ.M. PengZ.R. Treatment of capitellum cartilage injuries concomitant with radial head fractures. Chin.J. Hand Surg. Am.20143015375377
     [Google Scholar]
  3. WangJ. DingY.P. GuS.J. WuY.J. RuiY.J. YinQ.D. LiuY. Clinical characteristics of radial head fracture combined with capitulum cartilage injury.Chin J Orthopaedic Trauma20212311945951
     [Google Scholar]
  4. KaasL. TurkenburgJ.L. van RietR.P. VroemenJ.P.A.M. EygendaalD. Magnetic resonance imaging findings in 46 elbows with a radial head fracture.Acta Orthop.201081337337610.3109/17453674.2010.48398820450424
     [Google Scholar]
  5. NalbantogluU GereliA KocaogluB AktasS TurkmenM Capitellar cartilage injuries concomitant with radial head fractures.J Hand Surg A200833916021607
     [Google Scholar]
  6. RizzoM. NunleyJ.A. Fractures of the elbow’s lateral column radial head and capitellum.Hand Clin.2002181214210.1016/S0749‑0712(02)00011‑212143416
     [Google Scholar]
  7. ClaessenF. KachooeiA. VerheijK. KolovichG. MudgalC. Outcomes of concomitant fractures of the radial head and capitellum: the “Kissing Lesion”.J. Hand Microsurg.20168210010510.1055/s‑0036‑158543027625539
     [Google Scholar]
  8. WardW.G. NunleyJ.A. Concomitant fractures of the capitellum and radial head.J. Orthop. Trauma19882211011610.1097/00005131‑198802010‑000043230493
     [Google Scholar]
  9. MilchH. Unusual fractures of the capitulum humeri and the capitulum radii.J. Bone Joint Surg. Am.193113882886
     [Google Scholar]
  10. RolloG. RotiniR. EygendaalD. PichierriP. BisacciaM. PrkicA. StasiA. MeccarielloL. Effect of trochleocapitellar index on adult patient-reported outcomes after noncomminuted intra-articular distal humeral fractures.J. Shoulder Elbow Surg.20182771326133210.1016/j.jse.2018.02.07329907373
     [Google Scholar]
  11. GranthamS.A. NorrisT.R. BushD.C. Isolated fracture of the humeral capitellum.Clin. Orthop. Relat. Res.19811612622697307389
     [Google Scholar]
  12. MasonM.L. Some observations on fractures of the head of the radius with a review of one hundred cases.Br. J. Surg.20054217212313210.1002/bjs.1800421720313209035
     [Google Scholar]
  13. ParkI.J. RohY.T. ShinS.H. ParkH.Y. JeongC. KangS.H. Importance of detection of capitellar cartilage injuries concomitant with isolated radial head fractures: A retrospective clinical study.Acta Orthop. Traumatol. Turc.202155211211710.5152/j.aott.2021.2004633847572
     [Google Scholar]
  14. BöttcherJ. MartineauP. Transverse capitellar shear fracture with interposed radial head fragment. A previously unclassified type of distal humeral fracture.Trauma Case Rep.20192310023110.1016/j.tcr.2019.10023131388541
     [Google Scholar]
  15. HarbrechtA. HacklM. LeschingerT. WegmannK. SeyboldD. MüllerL.P. Radial head fractures with interposed capitellar cartilage fragment–hindrance to bone healing–a case series.Arch. Orthop. Trauma Surg.202114191615162410.1007/s00402‑021‑03895‑z33877448
     [Google Scholar]
  16. GreenspanA NormanA The radial head, capitellum view: Useful technique in elbow trauma.AJR198213861186118810.2214/ajr.138.6.1186
     [Google Scholar]
  17. RauschV. KönigshausenM. SchildhauerT.A. GessmannJ. SeyboldD. Fractures of the capitellum humeri and their associated injuries.Obere Extrem.2018131333710.1007/s11678‑018‑0441‑929527238
     [Google Scholar]
  18. BirchlerP. ErhardtJ. KaufmannJ. Concomitant fractures of the capitulum humeri and the caput radii.Unfallchirurg20191221767810.1007/s00113‑018‑0545‑030143823
     [Google Scholar]
  19. FramB.R. SeigermanD.A. IlyasA.M. Coronal shear fractures of the distal Humerus: A review of diagnosis, treatment, and outcomes.Hand202116557758510.1177/155894471987881731625402
     [Google Scholar]
  20. Martín FuentesA.M. Ramos PascuaL.R. Cecilia LópezD. Correlation between radiographic findings and clinical failure in monopolar radial head replacement.Arch. Orthop. Trauma Surg.20201401515810.1007/s00402‑019‑03273‑w31515620
     [Google Scholar]
  21. GramlichY. KrauschE. SteinT. Schmidt-HorlohéK. HoffmannR. KlugA. Mid-term clinical outcome comparison of long-stemmed monopolar osseointegrated and short-stemmed bipolar radial head prostheses.Arch. Orthop. Trauma Surg.2021141582383010.1007/s00402‑020‑03534‑z32720000
     [Google Scholar]
  22. CamenzindR.S. CucchiD. LeschingerT. HacklM. MüllerL.P. WegmannK. Screw placement in arthroscopically assisted osteosynthesis of radial head fractures using a reference k-wire in the radiocapitellar joint: A cadaveric study.Arch. Orthop. Trauma Surg.202214374111411610.1007/s00402‑022‑04605‑z36197491
     [Google Scholar]
  23. JeonI.H. MicicI.D. YamamotoN. MorreyB.F. Osborne-cotterill lesion: An osseous defect of the capitellum associated with instability of the elbow.AJR Am. J. Roentgenol.2008191372772910.2214/AJR.07.373918716100
     [Google Scholar]
  24. VargasD.G. WoodcockS. PortoG.F. GonzalezJ.C. Osborne-Cotterill lesion a forgotten injury: Review article and case report.Clin. Shoulder Elbow2020231273010.5397/cise.2019.0031833330230
     [Google Scholar]
  25. YangY. YinQ. LiD. RuiY. WuY. DingY. JiangY. A new classification and its value evaluation for intermediate column fractures of the distal radius.J. Orthop. Surg. Res.201813122110.1186/s13018‑018‑0925‑830176895
     [Google Scholar]
  26. İmerciA. AydoganN.H. TosunK. Evaluation of inter- and intra-observer reliability of current classification systems for subtrochanteric femoral fractures.Eur. J. Orthop. Surg. Traumatol.201828349950210.1007/s00590‑017‑2065‑y29110093
     [Google Scholar]
/content/journals/cmir/10.2174/0115734056304073240625100529
Loading
Comprehensive Classification of the Capitellar Injury Concurrent with Radial Head Fracture
Curr. Med. Imaging 20, e15734056304073 (2024); https://doi.org/10.2174/0115734056304073240625100529
/content/journals/cmir/10.2174/0115734056304073240625100529
/content/journals/cmir/10.2174/0115734056304073240625100529
Loading

Data & Media loading...


  • Article Type:     Research Article
Keyword(s): Capitellar cartilage injury; Capitellar fracture; Capitellar injury concurrent with radial head fracture; Injury; Radial head fracture; Surgical methods

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test