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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, includingmales 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. Therewas 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.
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OBJECTIVE: The aim of this study was to investigate the clinical characteristics of cluster headache (CH) in a neurology outpatient population in China. METHODS: A cross-sectional survey was conducted from June to December 2011 in a tertiary care, university-affiliated hospital. All consecutive patients citing headache as their chief complaint were asked to participate in a face-to-face interview with a qualified headache specialist and to complete a detailed self-administered questionnaire. The diagnosis of CH was made according to the International Classification of Headache Disorders, Second Edition (ICHD-II). RESULTS: Of the 1,526 headache patients screened, 26 were diagnosed with CH (6 women, 20 men). Mean age at onset was 27 ± 8 years (range, 17-47), and 50% of patients were 20-30 years of age. Of the 26 CH patients, 61.5% reported that pain was usually centered at the right temporal region, and 69.2% characterized the pain as swelling. Attacks lasted 87 minutes on average and were associated with cranial autonomic symptoms (100%). A seasonal predilection was reported by 69.2% of CH patients. No patient reported significant changes in pain severity after physical activity. Tobacco use was common (14/26 patients), and alcohol was the most frequently cited trigger. CONCLUSIONS: This study details the clinical features of CH in a neurology outpatient population in China. Compared with Western studies, our patients were different in several aspects including the absence of chronic CH.