上腕骨小頭離断性骨軟骨炎33症例の手術成績

Outcome of Surgical Treatment of 33 Cases for Osteochondritis Dissecans of the Capitellum

　上腕骨小頭離断性骨軟骨炎の手術症例について治療成績と再手術の原因を検討した．2000年から2010年までに手術を行った33肘を対象とした．病巣分類は中央型10例，外側型4例，広範囲型19例であった．術前後の可動域とJOAスコア，術後1年での競技復帰率を評価し，また再手術症例の原因について検討した．可動域，JOAスコアとも術後改善を認め，術後1年での競技復帰率は平均90.3％であった．しかし骨軟骨柱固定術を施行した分離期後期の広範囲型の症例8例中4例，50％で再手術となった．

　The purpose of this study was to investigate the outcome of surgical treatment of osteochondritis dissecans (OCD) of the capitellum, and to analyze the reasons for reoperation.　The 33 cases in which surgery was used to treat OCD between 2000 and 2010 were investigated retrospectively.　The focus lesions were of the centralized type in 10 patients, lateral type in 4 patients, and widespread type in 19 patients.　Range of motion, elbow rating system, return to sports, and reasons for reoperation were analyzed.　Both range of motion and the elbow rating system of all patients improved after surgery.　The rate of return to sports was 90.3%.　However, 4 (50%) of the 8 patients in whom osteochondral peg fixation was performed required reoperation, and the lesions in all four patients were the widespread type and grade 2b.