Eichenauer M, Wödlinger R
Universitätsklinik für Orthopädie, Innsbruck.
Orthopade. 1988 Aug;17(4):374-81.
In our opinion, complete (Panner's disease) and incomplete (osteochondrosis dissecans; OD) necrosis of the elbow epiphysis form a nosologic unit. A review of the localization, pathogenetic hypotheses, symptoms, diagnosis and treatment of aseptic necrosis and OD of the elbow is presented with reference to the older and, especially, the current literature. In contrast to the procedures reported in the literature, we performed subchondral focus drilling in 10 patients over 10 years of age suffering from Panner's disease, with good functional results. Operative therapy was performed on 50 elbow affected by OD. Follow-up examinations were possible in 35, with an average observation period of 94.3 months. The results are categorized according to the stage of disease before treatment. It is desirable to perform surgical treatment at an early stage of the disease, since this can make it possible to avoid dissection. If dissecion is present, refixation early in the middle stage seems to be the treatment of choice.
我们认为,肘部骨骺的完全性(潘纳氏病)和不完全性(剥脱性骨软骨炎;OD)坏死构成一个疾病分类单位。本文参考早期文献,尤其是当前文献,对肘部无菌性坏死和OD的定位、发病机制假说、症状、诊断及治疗进行综述。与文献报道的手术方法不同,我们对10例年龄超过10岁的潘纳氏病患者进行了软骨下病灶钻孔术,取得了良好的功能效果。对50例肘部剥脱性骨软骨炎患者进行了手术治疗。其中35例进行了随访检查,平均观察期为94.3个月。结果根据治疗前疾病阶段进行分类。在疾病早期进行手术治疗是可取的,因为这样可以避免骨片分离。如果存在骨片分离,在疾病中期早期进行重新固定似乎是首选治疗方法。