Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.
J Hand Surg Am. 2024 Feb;49(2):150-159. doi: 10.1016/j.jhsa.2023.08.012. Epub 2023 Oct 20.
Osteochondritis dissecans (OCD) of the capitellum occurs relatively infrequently but can be found in young overhead-throwing athletes, most commonly in baseball players and gymnasts. Although non-operative management can effectively treat stable lesions, unstable lesions can lead to debilitating symptoms of the elbow and diminished quality of life without surgical intervention. This article reviews methods of treating OCD of the capitellum categorized by stability, size, and patient characteristics, and seeks to familiarize the reader with the appropriate selection of osteochondral allograft versus autograft in treating large, unstable lesions. We complement this review with 3 case examples, each using either an osteochondral autograft or allograft, and discuss the decision-making methodology used in each case.
肱骨小头剥脱性骨软骨炎（OCD）相对少见，但可发生于年轻的过顶投掷运动员，最常见于棒球运动员和体操运动员。虽然非手术治疗可以有效治疗稳定的病变，但不稳定的病变可导致肘部虚弱症状和生活质量下降，如果不进行手术干预。本文综述了根据稳定性、大小和患者特征对肱骨小头剥脱性骨软骨炎的治疗方法，并旨在使读者熟悉在治疗大的、不稳定病变时选择合适的异体骨软骨移植与自体骨软骨移植。我们通过 3 个病例示例补充了这篇综述，每个病例都使用了异体骨软骨移植或自体骨软骨移植，并讨论了每个病例中使用的决策方法。
