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. Purpose: 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. Study Design: 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. Conclusion: Healing of osteochondritis dissecans lesions of the elbow can be achieved after fragment fixation with pull-out wiring and a bone grafting technique.