title: Elbow extension deficit: a rare case of an osteochondral lesion on the radial head.
abstract: BACKGROUND
  An extension deficit of the elbow joint can be caused by various pathologies such as arthroliths, posttraumatic scar tissues, synovitis, capsular fibrosis of the anterior joint compartment, osteophytes in the area of the olecranon fossa or osteochondral lesions (OCL). Arthroscopic treatment is a good therapeutic option for theses pathologies.
  
  
  OBJECTIVE
  We performed a standardized elbow arthroscopy in the case of an 18-year old male roofer presented with an extension deficit of 5° which had existed for several years. As physical activity, the patient performed boxing and BMX bicycle races. The patient had no history of any kind of previous elbow surgery, injury, inflammatory or metabolic rheumatic disease or haemophilia.
  
  
  METHODS
  In the arthroscopic evaluation, we found a central OCL of the radial head with reactive capsular hypertrophy. The OCL was treated by microfracture with a chondropic. The clinical outcome was assessed by the Disability of Arm, Shoulder and Hand (DASH) score.
  
  
  RESULTS
  The restoration of the elbow joints full range of the motion (ROM) was achieved by arthroscopic treatment and adhesiolysis. In the follow-up examination one year after arthroscopy, the patient was asymptomatic and the elbow joint could be moved freely. Evaluation of the DASH score showed an improvement from a preoperative score of 7.0 to a postoperative score of 2.6.
  
  
  CONCLUSIONS
  Arthroscopy of the elbow is a good tool to treat OCL on the radial head. In cases of an extension deficit of the elbow, an OCL should be considered as a differential diagnosis.
authors.affiliation: Department of Orthopaedic Sports Surgery, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Lahner
authors.affiliation: Biomechanics Laboratory Department of Sport and Movement Sciences, University of Duisburg-Essen, Essen, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Hagen
authors.affiliation: Faculty of Health Sciences, University of Witten/Herdecke, Witten, Germany.
authors.forename: Lars Victor
authors.initials: LV
authors.lastname: von Engelhardt
authors.affiliation: Department of Orthopaedic Surgery, Annastift Hannover (Medical School Hannover, MHH), Hannover, Germany.
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Daniilidis
mesh_terms: D000293:Adolescent; D001182:Arthroscopy / Q000379:methods; D003286:Contracture / Q000209:etiology / Q000473:pathology / Q000601:surgery; D004551:Elbow Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010008:Osteochondritis Dissecans / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011884:Radius / Q000473:pathology / Q000601:surgery; D016059:Range of Motion, Articular
keywords: Elbow arthroscopy; extension deficit; osteochondral lesion; radial head