Are bone bruises a possible cause of osteochondritis dissecans of the capitellum? A case report and review of the literature.
A 17-year old soccer-player sustained a fracture and dislocation of the ulnar epicondyle combined with a bone bruises at the radial head and the capitellum. An open reduction and internal fixation was performed using two K-wires. Initial recovery was uneventful. After the operation he was discharged home and reviewed on a regular basis. When bony union had occurred the two K-wires were removed. However, on follow up he continued to complain of pain on the radial aspect of the joint and did not regain his normal range of movement. A further MRI was performed. Now a grade II osteochondritis dissecans not visible on the previous MRI taken 12 weeks earlier was clearly visualised. Treatment was continued conservatively with physiotherapy but avoiding aggressive mobilisation. On final review 6 months later he was able to move painfree with residual limitation of movement (ROM 0-5-130 degrees). Another MRI taken now was assessed as normal.
Fa
Krappel
K
Orthopädische Klinik, Medizinisches Zentrum Kreis Aachen, Mauerfeldchen 25, 52146 Würselen, Germany. fkrappel@yahoo.com
E
Bauer
B
U
Harland
H
D000293:Adolescent; D003288:Contusions / Q000175:diagnosis; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010008:Osteochondritis Dissecans / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012916:Soccer / Q000293:injuries*; D014458:Ulna Fractures / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D000092464:Elbow Injuries