Capitellar Fracture S42.456A 812.44

 elbow anatomy

Elbow cross section anatomy


synonyms:capitellar fracture, distal humerus fracture, fracture of humerus, condyle unspecified, articular process NO, lower epiphysis, Osborne-Cotterill lesion, posterior capitellar osteochondral fracture. 

Capitellar Fracture ICD-10


A- initial encounter for closed fracture

B- initial encounter for open fracture

D- subsequent encounter for fracture with routine healing

G- subsequent encounter for fracture with delayed healing

K- subsequent encounter for fracture with nonunion

P- subsequent encounter for fracture with malunion

S- sequela

Capitellar Fracture ICD-9

  • 812.44 (fracture of humerus, condyle unspecified, articular process NO, lower epiphysis)

Capitellar Fracture Etiology / Epidemiology / Natural History

  • Isolated capitellar fractures are uncommon.
  • Women < men
  • Mechanism of injury: When elbow is hyperextended the radial head forcefully shears off the capitellum during posterior dislocation.

Capitellar Fracture Anatomy

  • Capitellar fractures often have extension into the trochlea (Buitton TG, JBJS 2009;91A:390).
  • see Elbow Anatomy.

Capitellar Fracture Clinical Evaluation

Capitellar Fracture Xray / Diagnositc Tests

  • A/P, lateral and oblique views of the elbow demonstrate fracture.
  • CT scan: typically indicated to fully asses fracture. 3D reconstructions with radius and ulna subtracted are beneficial.

Capitellar Fracture Classification / Treatment

  • Type I (Hahn-Steinthal / capitellar shear fracture): ORIF
  • Type II (Kocher-Lorenz / cartilage and thin layer of subchondral bone sheared off): arthroscopic fragment excision +/- microfracture
  • Type III (comminution or compression of the articular surface): arthroscopic fragment excision +/- microfracture.
  • Osborne-Cotterill lesion: osteochondral fracture in the posterolateral margin of the humeral capitellum generally associated with a radial head defect of the radial head and elbow dislocation.  Treatment = HemiCap (off label) or osteochondral grafting. 

Capitellar Fracture Associated Injuries / Differential Diagnosis

Capitellar Fracture Complications

Capitellar Fracture Follow-up Care

  • Post-op: compressive dressing, elevation
  • 1 week: Start PT focused on ROM and strengthening. AAROM, PROM.  AROM, free weights start at 3 weeks.
  • 6 weeks: progressive sport specific activity.
  • 3 months: Return to sport / full activities.
  • Elbow Arthroscopy Rehab Protocol
  • Elbow Outcome Measures

Capitellar Fracture Review References