著者

村田 英明 村上 恒二 宗重 博 浜田 宣和 天野 幹三 山本 健之 生田 義和

出版者

Japanese Society for Joint Diseases

雑誌

日本リウマチ・関節外科学会雑誌 (ISSN:02873214)

巻号頁・発行日

vol.12, no.3, pp.273-282, 1993-12-20 (Released:2010-10-07)

参考文献数

13

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To study the effectiveness of bone peg graft from the ulna for osteochondritis dissecans of the elbow joint, we analyzed 16 patients with bone peg graft who had various types of preoperative and postoperative findings. All the cases were baseball players except for one volleyball player. The onset ages ranged from 10 to 16 years (mean 11.2), and the periods from then to the operation from 5 to 72 months (mean 2.6 years) . The follow-up periods were from 12 to 29 months (mean 20 months) . Based on Minami's X-P classification, 8 cases were categorized into the stage of fragmentation and 8 into the stage of isolation. Patients were also classified with respect to the osteochondral lesion found during operation; 9 were without abrasion of the lesion or, if with it, without invasion of fibrocartilage into the lesion and were classified into Type 1. The 7 in which the osteochondral lesion was unstable due to the invasion of fibrocartilage were classified as Type 2. The results with regard to postoperative X-P were classified as excellent when the osteochondral lesion was repaired anatomically, as ‘good’ when the lesion was under repair and the osteosclerotic halo of the capitulum had disappeared, and as ‘poor’ when the halo remained. As a result, 7 Type 1 cases (78%) were excellent and 2 cases (22%) good, while one Type 2 case (14%) was excellent, 4 (57%) were good and 2 (29%) were poor. All patients were clinically not symptomatic and were satisfied with the surgery. We emphasized that bone peg graft could be indicated in all cases of osteochondral dissecans of the elbow joint and that there were difficulties in repairing osteochondral lesion in Type 2 (unstable) cases.