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

  • Eric Chen
  • Nirav K. PandyaEmail author
Pediatric Orthopedics (N Pandya, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pediatric Orthopedics
  2. Topical Collection on Pediatric Orthopedics

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.

Keywords

Osteochondritis dissecans Elbow osteochondral lesions Adolescent athletes Baseball players Gymnasts Revision surgery 

Notes

Compliance with Ethical Standards

Conflict of Interest

Eric Chen declares that he has no conflict of interest.

Nirav Pandya is a consultant for Orthopediatrics.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.San Francisco Orthopedic Residency ProgramSan FranciscoUSA
  2. 2.Department of Orthopedic Surgery, Benioff Children’s HospitalUniversity of California San FranciscoOaklandUSA

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