van den Bekerom Michel Pj, de Klerk Huub H, van Riet Roger
Amsterdam Shoulder and Elbow Center of Expertise (ASECE), OLVG, Amsterdam, The Netherlands.
Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
Shoulder Elbow. 2024 Mar;16(1 Suppl):24-34. doi: 10.1177/17585732231190011. Epub 2023 Jul 25.
Osteochondritis dissecans of the capitellum is debilitating and is a potentially sports career-ending injury in a young and athletic population. Osteochondritis dissecans typically occurs in patients between the ages of 10 and 24 years, and boys are more commonly affected than girls. Conventional radiographs have low diagnostic accuracy, and magnetic resonance imaging (with or without contrast) or computed tomography may aid in accurate diagnosis. The primary indication for non-operative treatment is the presence of an intact cartilage cap on magnetic resonance imaging, indicating a "stable lesion." However, if operative treatment is necessary, various surgical procedures are available when operative treatment for an osteochondritis dissecans of the capitellum is considered, including open or arthroscopic removal of loose bodies, with or without microfracturing, fragment fixation, osteochondral autograft transplantation, and osteochondral allograft transplantation. The decision-making process for selecting the appropriate treatment considers factors such as the patient's characteristics, functional limitations, and lesion morphology.
肱骨小头剥脱性骨软骨炎会使人虚弱，对于年轻且活跃的人群来说，这是一种可能终结运动生涯的损伤。剥脱性骨软骨炎通常发生在10至24岁的患者中，男孩比女孩更易受影响。传统X线片的诊断准确性较低，磁共振成像（有无造影剂）或计算机断层扫描可能有助于准确诊断。非手术治疗的主要指征是磁共振成像显示存在完整的软骨帽，表明为“稳定病变”。然而，如果需要手术治疗，在考虑对肱骨小头剥脱性骨软骨炎进行手术治疗时，有多种手术方法可供选择，包括开放或关节镜下取出游离体，有无微骨折、碎片固定、自体骨软骨移植和异体骨软骨移植。选择合适治疗方法的决策过程会考虑患者特征、功能限制和病变形态等因素。
