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Current Reviews in Musculoskeletal Medicine

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01-02-2020 | Osteochondrosis Dissecans | Pediatric Orthopedics (N Pandya, Section Editor)

Failure of Surgery for Osteochondral Injuries of the Elbow in the Pediatric and Adolescent Population

Authors: Eric Chen, Nirav K. Pandya

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2020

Abstract

Purpose of Review

With an increase in single-sport specialization, elbow injuries have become increasingly common in the pediatric and adolescent population. Osteochondritis dissecans (OCD) of the capitellum frequently requires intervention yet can be difficult to treat given high patient activity demands. The purpose of this paper is to review treatment options, understand failure rates, and provide strategies for successful revision surgery.

Recent Findings

Patients at high risk for the development of this condition are involved in high-demand upper extremity activity such as baseball or gymnastics. Treatment options include non-operative management, drilling, fixation, loose body removal/microfracture, osteochondral autograft, and osteochondral allograft. Cartilage preservation procedures (i.e., osteochondral autograft) have a significant advantage in terms of clinical and radiographic healing compared with fixation or microfracture.

Summary

Capitellar OCD lesions afflict a large number of adolescent athletes today and will likely continue increasing in number from sports-related injuries. It is critical to recognize and treat these lesions in a timely and appropriate fashion to optimize clinical outcomes. When faced with failure of healing, surgeons must critically analyze reasons for failure including post-operative compliance, return to high-demand sporting activity, fixation of non-viable fragments, utilization of microfracture, alignment, and concomitant pathology.

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Title: Failure of Surgery for Osteochondral Injuries of the Elbow in the Pediatric and Adolescent Population
Authors: Eric Chen
Nirav K. Pandya
Publication date: 01-02-2020
Publisher: Springer US
Keyword: Osteochondrosis Dissecans
Published in: Current Reviews in Musculoskeletal Medicine / Issue 1/2020
Electronic ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-020-09606-2

At a glance: The STEP trials

Springer Medicine

Failure of Surgery for Osteochondral Injuries of the Elbow in the Pediatric and Adolescent Population

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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