Lindholm T S, Osterman K, Vankka E
Clin Orthop Relat Res. 1980 May(148):245-53.
In 36 patients treated for osteochondritis dissecans (OCD) of the elbow, ankle and hip during a period of 20 years in the same hospital, trauma seems to have been the main etiologic factor in about half of the patients. The first symptoms of the lesions occurred when the patients were between 15 and 20 years of age. Osteochondritis dissecans of the elbow was seen in 19 men. Osteochondritis dissecans in the ankle occurred in 6 men and 5 women. Osteochondritis dissecans in the hip appeared in 5 men and one woman. The first symptoms were pain and restriction of joint movement. Conservative treatment was satisfactory for about one-half of the patients. When operative treatment was indicated, extirpation of loose bodies or loosening fragments was the treatment of choice in OCD of the elbow and ankle. Fixation of the fragment gave satistfactory results in some cases of OCD of the hip. Late results were excellent in only about one-half of the patients. Osteoarthritic changes appeared in the hip, elbow, ankle, in order of decreasing frequency.
在同一家医院20年期间接受治疗的36例肘部、踝部和髋部剥脱性骨软骨炎(OCD)患者中,创伤似乎是约半数患者的主要病因。病变的首发症状出现在患者15至20岁之间。肘部剥脱性骨软骨炎见于19名男性。踝部剥脱性骨软骨炎发生在6名男性和5名女性中。髋部剥脱性骨软骨炎出现在5名男性和1名女性中。首发症状为疼痛和关节活动受限。约半数患者采用保守治疗效果满意。当需要进行手术治疗时,对于肘部和踝部的剥脱性骨软骨炎,摘除游离体或松动碎片是首选治疗方法。在某些髋部剥脱性骨软骨炎病例中,固定碎片取得了满意的效果。仅约半数患者的远期效果良好。髋部、肘部、踝部出现骨关节炎改变,频率依次降低。