とう骨頭前方脱臼を伴った上腕骨外か離断性骨軟骨炎の２例

Abstract

Two cases of osteochondritis dissecans (OCD) developing radial head dislocation are presented in this study. The first case was a 13-year-old male who started playing baseball at nine years of age. He experienced a right elbow pain at 12 years. He had been treated conservatively for a year. Pain had relieved, however, severe pain and locking in the elbow occurred. Plain X-ray film showed OCD and radial head dislocation. The right radial head had widened and looked longer than left one. Firstly, the detached osteochondral free body was removed and wedge osteotomy was accomplished in the lateral humeral condyle. Reduction of the radial head was observed but pain in the radio-humeral joint still continued. Thereafter, radial shortening by approximately seven millimeters was performed. Pain was relieved perfectly and he now plays volleyball without any problems in his elbow. The second case was a 14-year-old male started playing baseball at 10 years of age. He experienced right elbow pain at 13 years. He underwent an operation to reattach the free osteochondral part. The reattached fragment was not reunited. Radial dislocation developed during this post-operative period. Since elbow pain persisted and elbow range of motion was increasingly limited, wedge osteotomy was perforned on the lateral humeral condyle. Reduction of the radial head was observed and elbow pain subsided. MRI-imaging revealed that OCD was located in the anterior capitulum in both cases. In this condition, radial head dislocation nay occur, conplicating treatment. Great care must be taken to ersure that the radial head of OCD patients does not develop secondary deformity in the elbow joints in adolescents.