title: A surgical treatment for unstable osteochondritis dissecans lesions of the humeral capitellum in adolescent baseball players.
abstract: BACKGROUND
  Various methods of surgical treatment for unstable osteochondritis dissecans lesions of the humeral capitellum have shown the potential to lead to osteoarthritis and poor functional results in throwing activities.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the results of surgical treatment with pull-out wiring and bone grafting (as established by Kondo in 1989) in patients with unstable osteochondritis dissecans lesions of the humeral capitellum.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Eleven male baseball players (average age, 14.7 years) with unstable osteochondritis dissecans lesions underwent internal fixation with pull-out wiring and bone grafting. Follow-up was an average 57 months. At an average 17 weeks after surgery, bony union of the osteochondritis dissecans lesion was radiographically confirmed and the wires were removed. Throwing was allowed beginning at 6 months after surgery.
  
  
  RESULTS
  At follow-up, all patients had obtained pain relief, and all except one had returned to previous throwing levels. Radiographs showed good healing, and minimal degenerative changes were found in only three joints.
  
  
  CONCLUSIONS
  Healing of osteochondritis dissecans lesions of the elbow can be achieved after fragment fixation with pull-out wiring and a bone grafting technique.
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Watarai
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsushita
authors.forename: Takao
authors.initials: T
authors.lastname: Saito
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Terashima
mesh_terms: D000293:Adolescent; D001484:Baseball / Q000293:injuries*; D016025:Bone Transplantation; D002648:Child; D002985:Clinical Protocols; D005593:Fracture Fixation, Internal; D006801:Humans; D006811:Humerus / Q000293:injuries*; D008297:Male; D010008:Osteochondritis Dissecans / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D000092464:Elbow Injuries