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The American Journal of Sports Medicine 27:728-732 (1999)
© 1999 American Orthopaedic Society for Sports Medicine

Nonoperative Treatment of Osteochondritis Dissecans of the Humeral Capitellum

Masatoshi Takahara, MD*,{dagger}, Toshihiko Ogino, MD*, Shigenobu Fukushima, MD*, Hiroyuki Tsuchida, MD* and Kiyoshi Kaneda, MD{ddagger}

* Department of Orthopaedic Surgery, Yamagata University School of Medicine, Yamagata City
{ddagger} Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo City, Japan

{dagger} Address correspondence and reprint requests to Masatoshi Takahara, MD, Department of Orthopaedic Surgery, Yamagata University School of Medicine, Iida-Nish 2, Yamagata City, 990-9585, Japan

We examined 24 patients with osteochondritis dissecans of the humeral capitellum to determine the results of nonoperative treatment. The average age of the patients at the initial examination was 13.3 years (range, 11 to 16). All the patients were advised to stop heavy use of the elbow for 6 months. At the last examination, at a mean follow-up period of 5.2 years, 4 patients (17%) had no residual elbow pain, 7 (29%) had pain only with heavy activities, and 13 (54%) had pain with activities of daily living. Final radiographs were obtained for 15 lesions, of which 3 lesions were assessed as healed, 3 as improved, and 9 as not improved. Five of 11 lesions in the early stage and all 4 advanced lesions failed to show radiographic improvement. These results suggest that osteochondritis dissecans of the capitellum has only a slight tendency to heal, and that instability can cause failure of the lesion to heal.




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