Overview
Osteochondritis dissecans (OCD) of the capitellum involves a localized loss of blood supply to the capitellum, leading to cartilage and subchondral bone damage, often seen in young athletes participating in overhead or contact sports 1.Diagnosis
Clinical Presentation: Pain, limitation of elbow extension, and occasionally elbow locking 1.
Imaging: MRI is crucial for assessing the extent of bone and cartilage involvement; X-rays may show early signs like subchondral radiolucency 1.
Grading: Not explicitly detailed in the abstract, but imaging findings help differentiate stages from stable lesions to loose bodies 1.Management
First-Line Treatment: Non-operative management initially, including immobilization followed by physical therapy 1.
Surgical Intervention: Indicated for persistent symptoms after conservative treatment, involving arthroscopic removal of loose bodies and drilling of the capitellum with bone grafting if necessary 1.
Specific Techniques: Arthroscopic exploration, loose body removal, drilling, and bone grafting from above the capitellum 1.Special Populations
Pediatrics: Common in adolescents aged 13-17, predominantly affecting males and dominant elbows in athletes like pitchers and catchers 1.Key Recommendations
Consider surgical intervention for persistent symptoms after non-operative management in pediatric patients with capitellar OCD 1 (Evidence: Weak).
Arthroscopic exploration and removal of loose bodies should be performed if conservative treatment fails 1 (Evidence: Weak).
Bone grafting may be beneficial in cases without loose fragments to promote healing 1 (Evidence: Weak).References
1 Tivnon MC, Anzel SH, Waugh TR. Surgical management of osteochondritis dissecans of the capitellum. The American journal of sports medicine 1976. link