Comprehensive Classification of the Capitellar Injury Concurrent with Radial Head Fracture

Title:Comprehensive Classification of the Capitellar Injury Concurrent with Radial Head Fracture

Volume: 20

Author(s): Huli Liu, Qianyun Xie, Yang Zhang, Ying Yang, Yan Jiang, Wen Tang*Sheng Song*

Affiliation:

• Department of Radiology, Wuxi No. 9 People's Hospital, Affiliated to Soochow University, Wuxi 214062, Jiangsu, P.R. China

• Department of Orthopaedics, Wuxi No. 9 People's Hospital, Affiliated to Soochow University, Wuxi 214062, Jiangsu, P.R. China

Keywords: Radial head fracture, Capitellar fracture, Capitellar cartilage injury, Capitellar injury concurrent with radial head fracture, Surgical methods, Injury.

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 (p > 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.

Cite this article as:

Liu Huli, Xie Qianyun, Zhang Yang, Yang Ying, Jiang Yan, Tang Wen*, Song Sheng*, Comprehensive Classification of the Capitellar Injury Concurrent with Radial Head Fracture, Current Medical Imaging 2024; 20 : e15734056304073 . https://dx.doi.org/10.2174/0115734056304073240625100529