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Capitellum Fracture
Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Capitulum fracture
                • Capitulum: Original anatomic name for capitellum
              • Osteochondral fracture
                • Term for acute injuries
                • Thinner fragment of articular cartilage and subchondral bone
              • Osteochondritis dissecans
                • Chronic repetitive injury from valgus forces
                • Adolescent throwers and tumblers
                • Findings overlap with acute osteochondral fracture
              • Panner disease
                • Uncertain etiology: Disordered cartilage growth vs. traumatic
                • Young children
                • Radiographic irregularity of entire capitellum growth center
                • Usually remodels by adulthood
              • Hahn-Steinthal fracture
              • Kocher-Lorenz fracture
              • Broberg-Morrey fracture
              • McKee fracture
              • Osborne-Cotterill lesion
            • Definitions

              • Fracture limited to articular surface of lateral condyle of humerus
              • May be osseous, osteochondral, or purely chondral

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Sułko J et al: Capitellar fractures in children. Ortop Traumatol Rehabil. 16(6):573-9, 2014
                                          2. Bancroft LW et al: Osteochondral lesions of the elbow. Semin Musculoskelet Radiol. 17(5):446-54, 2013
                                          3. Bilsel K et al: Coronal plane fractures of the distal humerus involving the capitellum and trochlea treated with open reduction internal fixation. Arch Orthop Trauma Surg. 133(6):797-804, 2013
                                          4. Kim JY et al: Fractures of the capitellum concomitant with avulsion fractures of the triceps tendon. J Hand Surg Am. 38(3):495-7, 2013
                                          5. Davis KW et al: Upper extremity injuries in young athletes. Semin Musculoskelet Radiol. 16(4):269-79, 2012
                                          6. Jans LB et al: MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children. Eur J Radiol. 81(6):1306-10, 2012
                                          7. Sherman SC: Capitellum fracture: detecting fat pads may have a significant impact on outcome. Am J Emerg Med. 30(1):264.e1-2, 2012
                                          8. Singh AP et al: Outcome of surgical treatment of type IV capitellum fractures in adults. Chin J Traumatol. 15(4):201-5, 2012
                                          9. Smith MV et al: Surgical treatment for osteochondritis dissecans of the capitellum. Sports Health. 4(5):425-32, 2012
                                          10. Sabo MT et al: Osteochondral lesions of the capitellum do not affect elbow kinematics and stability with intact collateral ligaments: an in vitro biomechanical study. J Hand Surg Am. 36(1):74-80, 2011
                                          11. Baker CL 3rd et al: Osteochondritis dissecans of the capitellum. Am J Sports Med. 38(9):1917-28, 2010
                                          12. Davis KW: Imaging pediatric sports injuries: upper extremity. Radiol Clin North Am. 48(6):1199-211, 2010
                                          13. Mihara K et al: Surgical treatment for osteochondritis dissecans of the humeral capitellum. J Shoulder Elbow Surg. 19(1):31-7, 2010
                                          14. Ruchelsman DE et al: Osteochondritis dissecans of the capitellum: current concepts. J Am Acad Orthop Surg. 18(9):557-67, 2010
                                          15. Cottalorda J et al: The often-missed Kocher-Lorenz elbow fracture. Rev Chir Orthop Traumatol. 95(7):551-4, 2009
                                          16. Guitton TG et al: Fractures of the capitellum and trochlea. J Bone Joint Surg Am. 91(2):390-7, 2009
                                          17. Singh AP et al: Fractures of capitellum: a review of 14 cases treated by open reduction and internal fixation with Herbert screws. Int Orthop. Epub ahead of print, 2009
                                          18. Jeon IH et al: Osborne-cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol. 191(3):727-9, 2008
                                          19. Cheung EV: Fractures of the capitellum. Hand Clin. 23(4):481-6, vii, 2007
                                          20. Sen MK et al: Open reduction and internal fixation of coronal fractures of the capitellum. J Hand Surg [Am]. 32(9):1462-5, 2007
                                          21. Kijowski R, De Smet AA. MRI findings of osteochondritis dissecans of the capitellum with surgical correlation. Am J Roentgenol. 185:1453-9, 2005
                                          22. Faber KJ: Coronal shear fractures of the distal humerus: the capitellum and trochlea. Hand Clin. 20(4):455-64, 2004
                                          23. Kobayashi K et al: Lateral compression injuries in the pediatric elbow: Panner's disease and osteochondritis dissecans of the capitellum. J Am Acad Orthop Surg. 12(4):246-54, 2004
                                          24. Rizzo M et al: Fractures of the elbow's lateral column radial head and capitellum. Hand Clin. 18(1):21-42, 2002
                                          25. McKee MD et al: Coronal shear fractures of the distal end of the humerus. J Bone Joint Surg Am. 78(1):49-54, 1996
                                          26. Rosenberg ZS et al: Pseudodefect of the capitellum: potential MR imaging pitfall. Radiology. 191(3):821-3, 1994
                                          27. Bryan RS et al. Fractures of the distal humerus. In Morrey BF (ed.): The Elbow and Its Disorders. Philadelphia: WB Saunders. 302-39, 1985
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Capitulum fracture
                                                        • Capitulum: Original anatomic name for capitellum
                                                      • Osteochondral fracture
                                                        • Term for acute injuries
                                                        • Thinner fragment of articular cartilage and subchondral bone
                                                      • Osteochondritis dissecans
                                                        • Chronic repetitive injury from valgus forces
                                                        • Adolescent throwers and tumblers
                                                        • Findings overlap with acute osteochondral fracture
                                                      • Panner disease
                                                        • Uncertain etiology: Disordered cartilage growth vs. traumatic
                                                        • Young children
                                                        • Radiographic irregularity of entire capitellum growth center
                                                        • Usually remodels by adulthood
                                                      • Hahn-Steinthal fracture
                                                      • Kocher-Lorenz fracture
                                                      • Broberg-Morrey fracture
                                                      • McKee fracture
                                                      • Osborne-Cotterill lesion
                                                    • Definitions

                                                      • Fracture limited to articular surface of lateral condyle of humerus
                                                      • May be osseous, osteochondral, or purely chondral

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Sułko J et al: Capitellar fractures in children. Ortop Traumatol Rehabil. 16(6):573-9, 2014
                                                                                  2. Bancroft LW et al: Osteochondral lesions of the elbow. Semin Musculoskelet Radiol. 17(5):446-54, 2013
                                                                                  3. Bilsel K et al: Coronal plane fractures of the distal humerus involving the capitellum and trochlea treated with open reduction internal fixation. Arch Orthop Trauma Surg. 133(6):797-804, 2013
                                                                                  4. Kim JY et al: Fractures of the capitellum concomitant with avulsion fractures of the triceps tendon. J Hand Surg Am. 38(3):495-7, 2013
                                                                                  5. Davis KW et al: Upper extremity injuries in young athletes. Semin Musculoskelet Radiol. 16(4):269-79, 2012
                                                                                  6. Jans LB et al: MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children. Eur J Radiol. 81(6):1306-10, 2012
                                                                                  7. Sherman SC: Capitellum fracture: detecting fat pads may have a significant impact on outcome. Am J Emerg Med. 30(1):264.e1-2, 2012
                                                                                  8. Singh AP et al: Outcome of surgical treatment of type IV capitellum fractures in adults. Chin J Traumatol. 15(4):201-5, 2012
                                                                                  9. Smith MV et al: Surgical treatment for osteochondritis dissecans of the capitellum. Sports Health. 4(5):425-32, 2012
                                                                                  10. Sabo MT et al: Osteochondral lesions of the capitellum do not affect elbow kinematics and stability with intact collateral ligaments: an in vitro biomechanical study. J Hand Surg Am. 36(1):74-80, 2011
                                                                                  11. Baker CL 3rd et al: Osteochondritis dissecans of the capitellum. Am J Sports Med. 38(9):1917-28, 2010
                                                                                  12. Davis KW: Imaging pediatric sports injuries: upper extremity. Radiol Clin North Am. 48(6):1199-211, 2010
                                                                                  13. Mihara K et al: Surgical treatment for osteochondritis dissecans of the humeral capitellum. J Shoulder Elbow Surg. 19(1):31-7, 2010
                                                                                  14. Ruchelsman DE et al: Osteochondritis dissecans of the capitellum: current concepts. J Am Acad Orthop Surg. 18(9):557-67, 2010
                                                                                  15. Cottalorda J et al: The often-missed Kocher-Lorenz elbow fracture. Rev Chir Orthop Traumatol. 95(7):551-4, 2009
                                                                                  16. Guitton TG et al: Fractures of the capitellum and trochlea. J Bone Joint Surg Am. 91(2):390-7, 2009
                                                                                  17. Singh AP et al: Fractures of capitellum: a review of 14 cases treated by open reduction and internal fixation with Herbert screws. Int Orthop. Epub ahead of print, 2009
                                                                                  18. Jeon IH et al: Osborne-cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol. 191(3):727-9, 2008
                                                                                  19. Cheung EV: Fractures of the capitellum. Hand Clin. 23(4):481-6, vii, 2007
                                                                                  20. Sen MK et al: Open reduction and internal fixation of coronal fractures of the capitellum. J Hand Surg [Am]. 32(9):1462-5, 2007
                                                                                  21. Kijowski R, De Smet AA. MRI findings of osteochondritis dissecans of the capitellum with surgical correlation. Am J Roentgenol. 185:1453-9, 2005
                                                                                  22. Faber KJ: Coronal shear fractures of the distal humerus: the capitellum and trochlea. Hand Clin. 20(4):455-64, 2004
                                                                                  23. Kobayashi K et al: Lateral compression injuries in the pediatric elbow: Panner's disease and osteochondritis dissecans of the capitellum. J Am Acad Orthop Surg. 12(4):246-54, 2004
                                                                                  24. Rizzo M et al: Fractures of the elbow's lateral column radial head and capitellum. Hand Clin. 18(1):21-42, 2002
                                                                                  25. McKee MD et al: Coronal shear fractures of the distal end of the humerus. J Bone Joint Surg Am. 78(1):49-54, 1996
                                                                                  26. Rosenberg ZS et al: Pseudodefect of the capitellum: potential MR imaging pitfall. Radiology. 191(3):821-3, 1994
                                                                                  27. Bryan RS et al. Fractures of the distal humerus. In Morrey BF (ed.): The Elbow and Its Disorders. Philadelphia: WB Saunders. 302-39, 1985