Abstract
Two cases of radial head fractures combined with osteochondral fractures of the capitellum were studied. In the case of a 22 years old male, multi X-ray views, tomography and CT were useful for the diagnosis of the osteochondral fracture of the capitellum (Kocher-Lorenz type) and the radial head fracture (Mason type 3). The radial head was fixed with Herbert screws and the osteochondral fracture of the capitellum was fixed with four #24 wires. Two weeks after the operation, ROM exercise was started with CPM. Five months after the operation, elbow function was almost excellent except a slight limitation of extension. In case 2 (59 years old male), X-ray examination clarified the radial head fracture but did not prove the osteochondral fracture of the capitellum but it was confirmed during the operation. The operation was performed by the same way as in case 1. The radial head fracture was fixed with Herbert screws and the osteochondral fracture of the capitellum was fixed with one #30 wire. Multiple X-ray views, tomography and CT are necessary for an accurate diagnosis of osteochondral fractures of the capitellum. A popular treatment of the osteochondral fracture of the capitellum is resection, but wide chondral defect may advance OA changes and elbow instability. If accurate reduction and proper fixation are possible, internal fixation is advisable. Wire fixation has some merit. The elbow joint movement is not restricted because the wire is buried slightly beneath the articular surface and can be removed without the joint being reentered.
