title: Panner's disease: literature review and treatment recommendations.
abstract: OBJECTIVE
  To determine the most up-to-date theory on the aetiology of Panner's disease, to form a consensus on the assessment of radiographs and to evaluate clinical outcome in order to summarise the best available evidence for diagnosis and treatment.
  
  
  METHODS
  A review of studies to date on Panner's disease. Studies were eligible if: (1) the study provided criteria for defining Panner's disease in order to eliminate confounding data on other radiographic entities that were mistakenly grouped and presented as Panner's disease; (2) original data of at least one patient was presented; (3) manuscripts were written in English, German or Dutch; and (4) a full-text article was available. Animal studies, reviews and expert opinions were not included. Because the majority of the studies were case reports, we did not use an overall scoring system to evaluate methodological quality.
  
  
  RESULTS
  Twenty-three articles reporting on Panner's disease were included. Most cases of Panner's disease were unilateral in distribution and occurred in boys during the first decade of life. In general, conservative treatment is advised for Panner's disease. Panner's disease is a self-limiting disease and the majority of patients heal without clinical impairment.
  
  
  CONCLUSIONS
  Based on the results of this review, Panner's disease should be treated conservatively. Uniform names and descriptions of signs on radiographs would help to make the correct diagnosis. Since Panner's disease is very rare, higher quality studies are not likely to be performed and, thus, this review provides the best level of evidence on the current knowledge about Panner's disease.
authors: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Harvard Medical School and University of Amsterdam Medical School, 55 Fruit Street, Boston, MA, 02114, USA, f.claessen@mgh.harvard.edu.
authors: Femke M A P
authors: FM
authors: Claessen
authors: Jan K G
authors: JK
authors: Louwerens
authors: Job N
authors: JN
authors: Doornberg
authors: C Niek
authors: CN
authors: van Dijk
authors: Denise
authors: D
authors: Eygendaal
authors: Michel P J
authors: MP
authors: van den Bekerom