Capitellar Injury Essay

Fractures of the capitellum humeri are rare injuries. High prevalence of this injury is found in women being 4 times more often than in men [10,31] and it has been suggested that this may be related to the greater carrying angle of the female elbow and weaker bones (osteoporosis)[11]. These injuries occur in young population and the female predominance in present series coincides well with the reported literature [31]. Capitellar fracture patients usually present with pain and swelling of the elbow immediately after injury. Fractures of the capitellum are frequently missed on first examination [28], as they are not clearly seen on anteroposterior radiographs because the fracture line is not well recognized against the profile of the distal humerus because of overlap. They are typically picked and best seen on true lateral views (Figure 6 -A, B) [28]. A high index of suspicion and good lateral view radiograph is thus warranted to avoid missing this injury. Additionally in type IV injuries on a lateral view radiograph, a pathognomonic ‘double-arc sign’ formed by the subchondral bone of the capitellum and the lateral trochlear ridge is often seen ( Figure 7 -A,B) [9].
CT scan with 3D …show more content…
In our study, nine patients were categorized as Type I. Type II (Kocher-Lorenz) and Type III (comminuted) fractures of the capitellum are found in considerably lower numbers. No case of Type II and Type III were present in this study. Type IV (McKee) makes up about 36% of capitellum fractures in women, while it is found in 54% of cases in men[14]. In our study from 15 cases, we had six Type IV fractures. Capitellum fractures with radial head fracture occurs in 24% of cases[14]. This series had 2 cases with radial head fractures and one with lateral epicondylar