Kessler Jeffrey I, Jacobs John C, Cannamela Peter C, Weiss Jennifer M, Shea Kevin G
Kaiser Permanente Southern California, Los Angeles, California, USA.
Department of Emergency Medicine, Indiana University, Indianapolis, Indiana, USA.
Orthop J Sports Med. 2018 Dec 19;6(12):2325967118815846. doi: 10.1177/2325967118815846. eCollection 2018 Dec.
Osteochondritis dissecans (OCD) of the elbow is a disorder of subchondral bone and articular cartilage, of which the incidence among children is not clearly known.
To assess the demographics and epidemiology of OCD of the elbow among children.
Cross-sectional study; Level of evidence, 3.
A retrospective chart review of an integrated health system for the years 2007 through 2011 was performed for patients with elbow OCD aged 2 to 19 years. Lesion location, laterality, and all patient demographics were recorded. OCD incidence was determined for the group as a whole as well as by sex and age group (2-5, 6-11, 12-19 years). Patient differences based on age, sex, and ethnicity were analyzed, and multivariable logistic regression models were used to assess the risk of elbow OCD by group.
A total of 37 patients with 40 OCD lesions fit the inclusion criteria. No lesion was found among 2- to 5-year-olds. A majority of lesions (n = 39, 97.5%) were in the capitellum, and 1 (2.5%) was in the trochlea. Twenty-five patients (67.6%) had right-sided lesions; 9 (24.3%), left-sided; and 3 (8.1%), bilateral. The incidence of elbow OCD for patients aged 6 to 19 years was 2.2 per 100,000 overall and 3.8 and 0.6 per 100,000 for males and females, respectively. The majority of OCD cases were seen in those aged 12 to 19 years, with an incidence of 3.4 per 100,000 versus 0.38 among 6- to 11-year-olds. Multivariable logistic regression analysis revealed a 21.7-times increased odds ratio of elbow OCD among patients aged 12 to 19 years versus 6 to 11 years, and males had a 6.8-times greater odds ratio of elbow OCD than females ( < .0001 for both). Based on race and ethnicity, non-Hispanic whites had the highest incidence of elbow OCD as compared with all other ethnic groups.
In this population-based cohort study of pediatric elbow OCD, males had almost 7 times the risk of elbow OCD as compared with females, and 12- to 19-year-olds had nearly 22 times the risk of elbow OCD versus 6- to 11-year-olds. In keeping with many prior studies, the majority of patients had right-sided lesions.
肘关节剥脱性骨软骨炎（OCD）是一种软骨下骨和关节软骨疾病，其在儿童中的发病率尚不清楚。
评估儿童肘关节OCD的人口统计学和流行病学特征。
横断面研究；证据等级为3级。
对2007年至2011年综合医疗系统中年龄在2至19岁的肘关节OCD患者进行回顾性病历审查。记录病变位置、侧别和所有患者的人口统计学信息。确定整个组以及按性别和年龄组（2至5岁、6至11岁、12至19岁）的OCD发病率。分析基于年龄、性别和种族的患者差异，并使用多变量逻辑回归模型评估各年龄组患肘关节OCD的风险。
共有37例患者的40处OCD病变符合纳入标准。2至5岁儿童未发现病变。大多数病变（n = 39，97.5%）位于肱骨小头，1处（2.5%）位于滑车。25例患者（67.6%）为右侧病变；9例（24.3%）为左侧病变；3例（8.1%）为双侧病变。6至19岁患者肘关节OCD的总体发病率为每10万人2.2例，男性和女性的发病率分别为每10万人3.8例和0.6例。大多数OCD病例见于12至19岁的患者，发病率为每10万人3.4例，而6至11岁患者的发病率为每10万人0.38例。多变量逻辑回归分析显示，12至19岁患者患肘关节OCD的优势比是6至11岁患者的21.7倍，男性患肘关节OCD的优势比是女性的6.8倍（两者均P <.0001）。基于种族和民族，非西班牙裔白人的肘关节OCD发病率高于所有其他种族群体。
在这项基于人群的儿童肘关节OCD队列研究中，男性患肘关节OCD的风险几乎是女性的7倍，12至19岁患者患肘关节OCD的风险是6至11岁患者的近22倍。与许多先前的研究一致，大多数患者为右侧病变。
