Chondral lesion of capitellum humeri accompanying radial head fracture: a case report

Yıl 2015, Cilt: 1 Sayı: 1, 21 - 23, 04.03.2015

Murat Songur Ercan Sahin Mahmut Kalem Sinan Zehir

https://doi.org/10.18621/eurj.2015.1.1.21

Öz

In this case report we present a case of full thickness chondral lesion of anterior-distal surface of capitellum humeri, accompanying an intra-articular radial head fracture. Importance of this case is the resemblance of chondral injury to Lorenz-Kocher lesion of humerus and atypical displacement of chondral fragments. A 32-year-old male, admitted to emergency room after fall on his right upper extremity. X-ray and CT scan of elbow revealed a minimally displaced radial head fracture (Mason type 2), with a 4 mm step (depression) at joint surface. During the operation, at the anterior surface of the distal humerus, a full thickness chondral lesion was encountered. After removal of chondral fragments from the fractured radial head surface, it was seen that these fragments were of capitellar origin. Following radial head fixation, early active assistive motion was started. At the 6 month visit, the patient was pain-free with full participation in activities of daily living with a DASH score of 12,5. This injury is important due to demonstration of such an extensile injury in spite of benign looking radiology. Although radial head fractures were described, these type of occult injuries may be responsible from unexplainable and unfavorable outcome following low energy radial head fractures, treated conservatively.

Anahtar Kelimeler

Cartilage lesion, radial head fracture

Kaynakça

• Zwingmann J, Welzel M, Dovi-Akue D, Schmal H, Südkamp NP, Strohm PC. Clinical results after different operative treatment methods of radial head and neck fractures. A systematic review and meta-analysis of clinical outcome. Injury. 2013 Nov;44(11):1540-50.
• Duguet B, Le Saout J. Fractures du capitellum chez l'enfant [Capitellum fractures of children (author's transl)]. Chir Pediatr. 1980;21(5):331-3. [Article in French].
• Hope PG, Williamson DM, Coates CJ, Cole WG. Biodegradable pin fixation of elbow fractures in children. J Bone Joint Surg Br. 1991 Nov;73(6):965-8.
• Cottalorda J , Bourelle S. The often missed Kocher-Lorenz elbow fracture. Orthop Traumatol Surg Res. 2009 Nov;95(7):547-50.
• Nalbantoglu U, Gereli A, Kocaoglu B, Aktas S, Turkmen M. Capitellar cartilage injuries concomitant with radial head fractures. J Hand Surg Am. 2008 Nov;33(9):1602-7.
• Caputo AE, Burton KJ, Cohen MS, King GJ. Articular cartilage injuries of the capitellum interposed in radial head fractures: a report of ten cases. J Shoulder Elbow Surg. 2006 Nov-Dec;15(6):716-20.
• Duckworth AD, Watson BS, Will EM, Petrisor BA, Walmsley PJ, Court-Brown CM, et al. Radial head and neck fractures: functional results and predictors of outcome. J Trauma. 2011 Sep;71(3):643-8.