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Acute Osteochondral Shear Fracture of the Capitellum in a Twelve-Year-Old PatientA Case Report
Jeffrey F. Sodl, MD1; Eric T. Ricchetti, MD1; G. Russell Huffman, MD, MPH1
1 Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Penn Sports Medicine Center, 235 South 33rd Street, Philadelphia, PA 19104. E-mail address for G.R. Huffman: russell.huffman@uphs.upenn.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at the Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Penn Sports Medicine Center, Philadelphia, Pennsylvania

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2008 Mar 01;90(3):629-633. doi: 10.2106/JBJS.G.00017
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The exact prevalence of radiocapitellar joint injuries in adolescents is unknown. The most common elbow disorders in young athletes include overuse injuries, such as osteochondritis dissecans and Panner disease. Fractures of the capitellum and radial neck can also occur in this age group as a result of direct trauma. Marion and Faysse reported only one capitellar fracture in a series of 2,000 elbow fractures in children1. Two fracture patterns of the capitellum have traditionally been described. The first type, a coronal shear fracture often referred to as the Hahn-Steinthal fracture, usually contains a large portion of cancellous bone from the lateral humeral condyle and may include the lateral crista of the trochlea as well2,3. The second type, a pure articular fracture called the Kocher-Lorenz fracture, has little or no subchondral bone attached to the fragment4,5 and is rarely seen in children6.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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