Takeba Jun, Takahashi Toshiaki, Watanabe Seiji, Imai Hiroshi, Kikuchi Satoshi, Umakoshi Kensuke, Matsumoto Hironori, Ohshita Muneaki, Miura Hiromasa, Aibiki Mayuki
Department of Emergency Medicine, Ehime University, Toon, Ehime, Japan.
Department of Orthopedic Surgery, Ehime University, Toon, Ehime, Japan.
J Shoulder Elbow Surg. 2015 Nov;24(11):1749-56. doi: 10.1016/j.jse.2015.07.009.
Reports regarding arthroscopic fixation of the osteochondral fragments for elbow osteochondritis dissecans (OCD) are few. This study assessed the clinical outcomes of arthroscopic fixation of unstable osteochondral fragments by using absorbable pins over a postoperative period of at least 1 year.
The patients were 13 adolescent baseball players with a mean age of 14 years (range, 12-16 years) who underwent OCD of primary lesions at International Cartilage Repair Society grades III and IV. The patients were evaluated by using validated outcome measures at a mean follow-up period of 24 months (range, 12-50 months).
The mean (standard deviation) score in the disability/symptom section of the Disabilities of the Arm, Shoulder, and Hand improved from 12.4 (6.0) before the surgery to 0.5 (1.2) after the surgery, and the sports section improved from 74.5 (25.4) to 1.4 (5.2). The mean (standard deviation) extension improved from -11° (10.8) to -2° (3.9; P < .001). The mean (SD) flexion improved from 129° (11.6) to 137° (5.6; P = .040). All patients were able to resume playing baseball, and 9 (69%) resumed playing at the same position as before their injuries.
The clinical results of arthroscopic osteochondral fragment fixation in the teenaged baseball players with elbow OCD, albeit obtained over only a short period, were favorable. This arthroscopic treatment enables repair of lesions and is considered appropriate for unstable OCD during the adolescent growth spurt.
关于肘关节剥脱性骨软骨炎（OCD）的关节镜下骨软骨碎片固定的报道较少。本研究评估了使用可吸收钢针进行关节镜下不稳定骨软骨碎片固定至少1年的临床疗效。
13例青少年棒球运动员，平均年龄14岁（范围12 - 16岁），国际软骨修复协会分级为III级和IV级原发性损伤的肘关节剥脱性骨软骨炎患者。采用经过验证的疗效指标对患者进行评估，平均随访时间为24个月（范围12 - 50个月）。
上肢、肩部和手部功能障碍残疾/症状部分的平均（标准差）评分从术前的12.4（6.0）改善至术后的0.5（1.2），运动部分评分从74.5（25.4）改善至1.4（5.2）。平均（标准差）伸展角度从-11°（10.8）改善至-2°（3.9；P < .001）。平均（标准差）屈曲角度从129°（11.6）改善至137°（5.6；P = .040）。所有患者均能够恢复打棒球，9例（69%）恢复至受伤前的相同位置打球。
青少年棒球运动员肘关节剥脱性骨软骨炎的关节镜下骨软骨碎片固定的临床结果虽然仅在短期内获得，但效果良好。这种关节镜治疗能够修复损伤，被认为适用于青少年生长突增期的不稳定肘关节剥脱性骨软骨炎。
