J Korean Fract Soc.  2018 Oct;31(4):154-158. 10.12671/jkfs.2018.31.4.154.

Capitellar Osteochondral Impacted Fracture of the Humerus in an Adult Female: A Case Report

• Yum J
• Seong M
• Kim K

• KMID: 2422897
• DOI: http://doi.org/10.12671/jkfs.2018.31.4.154

Abstract

Capitellar osteochondral impaction fractures of the humerus are an uncommon injury and not encompassed by commonly used classification systems, such as that of Bryan and Morrey. Only a few cases of capitellar osteochondral impaction fractures have been reported. We report a case of a 53-year-old female with a capitellar osteochondral impaction fracture. The osteochondral fracture fragment of the capitellum was impacted and there was a step-off on the articular surface. Recovery of congruence in the capitellar articular surface was necessary. Satisfactory clinical and radiological results were obtained through the "˜lever arm' reduction of the fracture fragment with a small osteotome and fixation with "˜raft' K-wire.

Keyword

Humerus; Capitellum fracture; Elbow injury; Osteochondral fracture; Impacted fracture

MeSH Terms

Adult*
Classification
Female*
Humans
Humerus*
Middle Aged

Figure

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  Fig. 1 Preoperative anteroposterior (A) and lateral (B) X-ray views of the left elbow were no visible fracture or dislocation.

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  Fig. 2 Computed tomography scans showed osteochondral depression of capitellum (white arrows).

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  Fig. 3 Operation photographs. (A) Articular surface depression of the capitellum (white arrow) and peeled articular cartilage of the radial head. (B) Small cartilage fragments from the radial head.

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  Fig. 4 (A) Impacted osteochondral fragment of capitellum was lifted to make an articular congruence (white arrow) using a small osteotome. (B) Stability was achieved using a ‘raft’ K-wire (white triangle).

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  Fig. 5 Postoperative anteroposterior (A) and lateral (B) X-ray views of the left elbow.

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  Fig. 6 Follow-up computed tomography scan shows the recovery of articular congruence of the capitellum (arrow).

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