scholarly journals Foot Loading Analysis of Intraarticular Tibia Pilon Fracture

2021 ◽  
Author(s):  
Anil Agar ◽  
Adem ŞAHİN ◽  
Seyit Ali Guclu ◽  
Deniz Gülabi ◽  
Cemil Erturk
Keyword(s):  
Functional Results ◽  
Pilon Fracture ◽  
Plantar Pressure Distribution ◽  
Functional Scores ◽  
The Mean ◽  
Foot Loading ◽  
Gait Function ◽  
Pilon Fractures ◽  
Loading Analysis

BACKGROUND: Although pilon fractures are rare, they are important for orthopedic surgeons because of the difficulty of treatment and adverse effects on gait function. The aim of the study to evaluate the relationship between the reduction quality of the fracture, functional results, ankle arthrosis and plantar pressure distribution in patients with tibia pilon fractures. METHODS: In this study, a total of 62 patients treated for an intraarticular pilon fracture in our clinic between January 2015 and January 2019 were evaluated retrospectively. Postoperative reduction qualities of the patients were evaluated with the Ovadia-Beals criteria, ankle functional scores with the Teeny-Wiss score, and ankle arthrosis with the Takakura classification. In the last follow-up of the patients, foot loading analysis was performed and the results of the patients were evaluated for their relation with postoperative reduction quality, ankle functions and ankle arthrosis. RESULTS: There were 62 patients (50 men and 12 women). The average age was 43.3 years (range 19-78). The mean follow-up was 34.3 months (range 24 - 58). The mean Ovadia-Beals score was 12.35 {plus minus} 4.6 in the postoperative plain radiographs of the patients; the mean Teeny-Wiss score in the last follow-up was 76.82 {plus minus} 17.69, and the Takakura score was 1.47 {plus minus} 1.35. Based on the pedobarographic measurements, 47.58% of the patients put weight on the anterior and 52.42% on the posterior of the foot in the anteroposterior plane. In the mediolateral plane, 42.15% loaded on the medial of the ankle and 57.85% loaded on the lateral of the foot. CONCLUSION: Intra-articular tibia pilon fractures can be demonstrated by lateralization of the walking axis and changes in gait patterns and can be associated with clinical outcome.

scholarly journals Is it justifiable to perform tibio-talar arthrodesis rather than fixation as the treatment for severe pilon fractures?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0039
Author(s):  
Jayasree Ramaskandhan ◽  
Malik Siddiqu ◽  
Sultan Qasim
Keyword(s):  
Functional Disability ◽  
Statistical Tests ◽  
Definitive Treatment ◽  
Pilon Fracture ◽  
Primary Osteoarthritis ◽  
Functional Scores ◽  
Group A ◽  
Group B ◽  
Pilon Fractures

Category: Trauma Introduction/Purpose: The purpose of this study was to compare functional outcome at minimum 2 years follow up post fixation of pilon fractures to that of patients undergoing elective procedure (in the form of TAR or ankle arthrodesis) for primary osteoarthritis of the ankle to assess whether pilon fracture patients would benefit from tibio-talar arthrodesis as a primary procedure rather than fixation to avoid significant functional disability between primary fixation and subsequent arthrodesis. Methods: This is a retrospective study of prospectively collected data of patients operated between April 2012 and December 2015. All patients with primary osteoarthritis undergoing elective TAR/arthrodesis (Group A) had pre-op functional scores recorded (MOX-FQ, EQ-5D and Foot and ankle outcome score FAOS). Patients with bilateral ankle arthritis, previous reconstructive surgery, inflammatory arthritis, hip and knee arthritis, spinal pathology and underlying neurological conditions were excluded from Group A. Patients in Group B (post Pilon fracture fixation with a minimum 2 year follow up) completed a postal questionnaire with the above scores. Outcomes between groups were compared using inferential statistical tests using SPSS. Results: Mean age of patients in Group A and Group B were (62.6 ± 10.9 years) and (46.4 ± 15 years) respectively; p<0.001. In group B, 9 patients (16.6%) had associated injuries and 45 patients (83.3%) had isolated injuries. 49 patients underwent an open reduction and internal fixation vs. 5 patients with hybrid fixator as a definitive management in Group B with 2 patients having significant infection (1 in each group). The results of functional scores comparing Group A to Group B (including sub-group analysis) are awaited and will be submitted subject to acceptance of this abstract. Conclusion: The outcomes of pilon fracture are well known to be poor with high rate of secondary osteoarthritis and significant functional disability associated with it in young individuals in active employment. The gold standard treatment for patients with significant osteoarthritis of the ankle is tibio-talar arthrodesis. However, a group of these patients continue to have high functional disability between initial injury and to the point of tibio-talar arthrodesis. The results of this study will highlight the justification to perform tibio-talar arthrodesis as a definitive treatment at the time of injury, rather than fixation.

scholarly journals A Novel Retensioning Technique for Arthroscopic Repair of PASTA Lesions: A Clinical and Radiologic Outcome Study of 24 Shoulders

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098688
Author(s):  
Su Cheol Kim ◽  
Jong Ho Jung ◽  
Sang Min Lee ◽  
Jae Chul Yoo
Keyword(s):  
Constant Score ◽  
Case Series ◽  
Tendon Healing ◽  
Shoulder Abduction ◽  
Level Of Evidence ◽  
Simple Shoulder Test ◽  
Shoulder Range Of Motion ◽  
Functional Scores ◽  
The Mean

Background: There is no consensus on the ideal treatment for partial articular supraspinatus tendon avulsion (PASTA) lesions without tendon damage. Purpose: To introduce a novel “retensioning technique” for arthroscopic PASTA repair and to assess the clinical and radiologic outcomes of this technique. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was performed on 24 patients whose PASTA lesion was treated using the retensioning technique between January 2011 and December 2015. The mean ± SD patient age was 57.6 ± 7.0 years (range, 43-71 years), and the mean follow-up period was 57.6 ± 23.4 months (range, 24.0-93.7 months). Sutures were placed at the edge of the PASTA lesion, tensioned, and fixed to lateral-row anchors. After surgery, shoulder range of motion (ROM) and functional scores (visual analog scale [VAS] for pain, VAS for function, American Shoulder and Elbow Surgeons [ASES] score, Constant score, Simple Shoulder Test, and Korean Shoulder Score) were evaluated at regular outpatient visits; at 6 months postoperatively, repair integrity was evaluated using magnetic resonance imaging (MRI). Results: At 12 months postoperatively, all ROM variables were improved compared with preoperative values, and shoulder abduction was improved significantly (136.00° vs 107.08°; P = .009). At final follow-up (>24 months), the VAS pain, VAS function, and ASES scores improved, from 6.39, 4.26, and 40.09 to 1.00, 8.26, and 85.96, respectively (all P < .001). At 6 months postoperatively, 21 of the 24 patients (87.5%) underwent follow-up MRI; the postoperative repair integrity was Sugaya type 1 or 2 for all of these patients, and 13 patients showed complete improvement of the lesion compared with preoperatively. Conclusion: The retensioning technique showed improved ROM and pain and functional scores as well as good tendon healing on MRI scans at 6-month follow-up in the majority of patients. Thus, the retensioning technique appears to be reliable procedure for the PASTA lesion.

Constrained liners revisited: favourable mid-term results in patients with high-risk of dislocation: technical considerations for the optimal outcome

2021 ◽  
pp. 112070002110107
Author(s):  
Eustathios Kenanidis ◽  
Panagiotis Kakoulidis ◽  
Panagiotis Anagnostis ◽  
Michael Potoupnis ◽  
Eleftherios Tsiridis
Keyword(s):  
High Risk ◽  
Recurrent Dislocation ◽  
Deep Infection ◽  
Consecutive Series ◽  
Revision Thas ◽  
Hip Stability ◽  
Functional Scores ◽  
Revision Tha ◽  
The Mean

Background: The outcomes of constrained liners (CLs) in total hip arthroplasty (THA) remain inconclusive. We evaluated the mid-term performance of CLs in a consecutive series of high-risk dislocation patients undergoing primary or revision THA performed by a single surgeon. The survival, dislocation rate, complications, and functional patients’ scores were assessed. Surgical tips to enhance outcomes were reviewed. Methods: 45 patients who received the Trident Tripolar CL between 2010 to 2019 were retrospectively evaluated from Arthroplasty Registry Thessaloniki. There were 17 primary and 28 revision THAs. The primary indications for using CL were severe abductor insufficiency or comorbidities, increasing the dislocation risk in primary, and recurrent dislocation or abductor insufficiency in revision THAs. The mean patient’s age was 68.5 (±14.5) years, and the mean follow-up 3.81 (±1.66) years. Results: There were 2 dislocations and 1 deep infection in the revision group. For any reason, the cumulative 6-year survival rate was 93.3%, 100% for primary, and 89.3% for revision THAs. The mean overall CL survival was 76.3 months for any reason (95% CI, 68.1–84.5) and 80.5 months for dislocation (95% CI, 75.8–85.2). The mean postoperative functional scores were significantly improved ( p < 0.001) at the latest follow-up. Conclusions: CLs can provide hip stability and durable fixation in selected low-demand patients with high-risk for dislocation after primary and revision THA at mid-term follow-up. Careful patient selection and the refined surgical technique aiming at the neutral liner position and considering the high CLs’ offset relative to stem-neck impingement are necessary to maximise outcomes.

scholarly journals Is Allograft Reconstruction of the Medial Ulnar Collateral Ligament of the Elbow a Viable Option for Nonelite Athletes? Outcomes at a Mean of 8 Years

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095914
Author(s):  
Justin C. Kennon ◽  
Erick M. Marigi ◽  
Chad E. Songy ◽  
Chris Bernard ◽  
Shawn W. O’Driscoll ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Ulnar Collateral Ligament ◽  
Ulnar Neuropathy ◽  
Complication Rates ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Functional Scores ◽  
The Mean

Background: The rate of elbow medial ulnar collateral ligament (MUCL) injury and surgery continues to rise steadily. While authors have failed to reach a consensus on the optimal graft or anchor configuration for MUCL reconstruction, the vast majority of the literature is focused on the young, elite athlete population utilizing autograft. These studies may not be as applicable for the “weekend warrior” type of patient or for young kids playing on high school leagues or recreationally without the intent or aspiration to participate at an elite level. Purpose: To investigate the clinical outcomes and complication rates of MUCL reconstruction utilizing only allograft sources in nonelite athletes. Study Design: Case series; Level of evidence, 4. Methods: Patient records were retrospectively analyzed for individuals who underwent allograft MUCL reconstruction at a single institution between 2000 and 2016. A total of 25 patients met inclusion criteria as laborers or nonelite (not collegiate or professional) athletes with a minimum of 2 years of postoperative follow-up. A review of the medical records for the included patients was performed to determine survivorship free of reoperation, complications, and clinical outcomes with use of the Summary Outcome Determination (SOD) and Timmerman-Andrews scores. Statistical analysis included a Wilcoxon rank-sum test to compare continuous variables between groups with an alpha level set at .05 for significance. Subgroup analysis included comparing outcome scores based on the allograft type used. Results: Twenty-five patients met all inclusion and exclusion criteria. The mean time to follow-up was 91 months (range, 25-195 months), and the mean age at the time of surgery was 25 years (range, 12-65 years). There were no revision operations for recurrent instability. The mean SOD score was 9 (range, 5-10) at the most recent follow-up, and the Timmerman-Andrews scores averaged 97 (range, 80-100). Three patients underwent subsequent surgical procedures for ulnar neuropathy (n = 2) and contracture (n = 1), and 1 patient underwent surgical intervention for combined ulnar neuropathy and contracture. Conclusion: Allograft MUCL reconstruction in nonelite athletes demonstrates comparable functional scores with many previously reported autograft outcomes in elite athletes. These results may be informative for elbow surgeons who wish to avoid autograft morbidity in common laborers and nonelite athletes with MUCL incompetency.

scholarly journals Role of leukocyte free platelet rich plasma in planter fasciitis: a prospective study

2017 ◽  
Vol 5 (12) ◽  
pp. 5432
Author(s):  
Chandre Shekhar ◽  
Alamgir Jhan ◽  
Ganesh Singh ◽  
Pankaj Singh ◽  
Shailendre S. Bhandhari
Keyword(s):  
Placebo Group ◽  
Functional Outcome ◽  
Platelet Rich Plasma ◽  
Functional Results ◽  
Visual Analogue Scale Pain ◽  
Functional Score ◽  
Outcome Scores ◽  
The Mean ◽  
Post Graduate Institute

Background: Planter fasciitis, is by definition, inflammation of planter fascia. Most of the cases are well treated conservatively and a few responds to surgery only. Objectives of present study were evaluating the efficacy of a single injection of leukocyte free platelet rich plasma in plantar fasciitis and to derive a correlation between the clinical and radiological outcome.Methods: The present study consisted of 120 patients of bilateral (PF), (240 feet). These patients were divided into two groups PRP group of 60 patients and Placebo group of 60 patients. The study was conducted on patients attending Orthopaedics outpatient department Post Graduate Institute of Medial Education and Research (PGIMER) from July 2011 to June 2012. A primary efficacy criterion was changes from baseline in pain using (VAS). Functional results, level of satisfaction and outcome were measured by – AOFAS Foot Scale. Correlation of clinical with radiological outcome were performed.Results: There was a significant decrease in the visual analogue scale (pain score) in the PRP. Group while in placebo group it was increased significantly at the end of 6 month. Functional outcome scores were improved significantly from their baseline values in PRP group while in placebo group the mean functional score were deteriorated at 6 months follow up. There was no improvement seen in functional status with normal saline injection. In PRP group the mean heal pad thickness was reduced significantly at 6 months follow up while in placebo group was not changed significantly at 6 months follow up. Correlation between radiological parameters and VAS was found to be positive while it was found negative with other functional outcome scores like AOFAS.Conclusions: Platelet-rich plasma (PRP), which is a natural concentrate of autologous growth factors,plays a role in the regeneration process in treatment of (PF).

scholarly journals Should Complex Comminuted C3-Type Tibial Pilon Fractures Be Fused or Fixated? A Systematic Review

2021 ◽  
Author(s):  
Yash Paul Chaudhry ◽  
Efstratios Papadelis ◽  
Hunter Hayes ◽  
Philip F. Stahel ◽  
Erik A. Hasenboehler
Keyword(s):  
Fracture Fixation ◽  
Complication Rate ◽  
Wound Complication ◽  
Ankle Arthrodesis ◽  
Pilon Fracture ◽  
Eligibility Criteria ◽  
Tibial Pilon ◽  
Mesh Terms ◽  
The Mean ◽  
Pilon Fractures

Abstract Background: Comminuted intra-articular tibial pilon fractures can be challenging to manage, with high revision rates and poor functional outcomes. This study reviewed (1) treatment, complications, and clinical outcomes in studies of complex comminuted tibial pilon fractures (type AO43-C3); and (2) primary ankle arthrodesis as a management option for these types of complex injuries.Methods: A systematic literature search was performed on PubMed from 1990-2020 to determine complications and outcomes after staged fracture fixation and primary ankle joint arthrodesis for comminuted C3-type tibial pilon fractures.The search was conducted in compliance with the PRISMA guidelines, using the following MeSH terms: “tibial pilon”/“pilon fracture”/“plafond fracture”/“distal tibial”/“43-C3”/“ankle fracture”/“ankle fusion”/“primary ankle arthrodesis”/“pilon fracture staged”/“pilon external fixation” and “pilon open reduction internal fixation.” Inclusion criteria were restricted to original articles in English language on adult patients ≥18 years of age. Eligibility criteria for retrieved publications were determined using a “PICO” approach (population, intervention/exposure, comparison, outcomes). Weighted analysis was used to compare treatment groups on time to definitive treatment, follow-up time, range of motion, fracture classification, and complications.Results: The systematic literature review using the defined MeSH terms yielded 72 original articles. Of these, 13 articles met the eligibility criteria based on the PICO statements, of which 8 publications investigated the outcomes of a staged fixation approach in 308 cumulative patients, and 5 articles focused on primary ankle arthrodesis in 69 cumulative patients. For staged treatment, the mean wound complication rate was 14.6%, and the malunion/nonunion rate was 9.9%. For primary arthrodesis, the mean wound complication rate was 2.9%, and the malunion/nonunion rate was 2.9%. After risk stratification for fracture type and severity, the small cumulative cohort of patients included in the primary arthrodesis publications did not provide sufficient power to determine a clinically relevant difference in complications and long-term patient outcomes compared to the staged surgical fixation group.Conclusions: At present, there is insufficient evidence in the published literature to provide guidance towards consideration of ankle arthrodesis for complex comminuted C3-type tibial pilon fractures, compared to the standard treatment by staged surgical fracture fixation.

Are the Classic and the Congruent Arc Latarjet Procedures Equally Effective for the Treatment of Recurrent Shoulder Instability in Athletes?

2020 ◽  
Vol 48 (9) ◽  
pp. 2081-2089
Author(s):  
Luciano A. Rossi ◽  
Ignacio Tanoira ◽  
Tomás Gorodischer ◽  
Ignacio Pasqualini ◽  
Domingo Luis Muscolo ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Bone Block ◽  
Return To Sports ◽  
Glenohumeral Instability ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Functional Scores ◽  
The Mean ◽  
Anterior Glenohumeral Instability

Background: There is a lack of evidence in the literature comparing outcomes between the classic and the congruent arc Latarjet procedures in athletes. Purpose: To compare return to sports, functional outcomes, and complications between the classic and the congruent arc Latarjet procedures in athletes with recurrent glenohumeral instability. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2009 and June 2017, 145 athletes with recurrent anterior glenohumeral instability underwent surgery with the Latarjet as a primary procedure in our institution. The classic procedure was used in 66 patients, and the congruent arc method was used in 79 patients. Return to sports, range of motion (ROM), the Rowe score, a visual analog scale (VAS) for pain in sports activity, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences were also evaluated. The postoperative bone block position and consolidation were assessed with computed tomography. Results: In the total population, the mean follow-up was 41.3 months (range, 24-90 months) and the mean age was 25.3 years (range, 18-45 years). In total, 90% of patients were able to return to sports; of these, 91% returned at their preinjury level of play. No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe, VAS, and ASOSS scores showed statistical improvement after operation ( P < .001). The Rowe score increased from a preoperative mean of 42.8 points to a postoperative mean of 95.2 points ( P < .01). Subjective pain during sports improved from 3.2 points preoperatively to 0.7 points at last follow-up ( P < .01). The ASOSS score improved significantly from a preoperative mean of 46.4 points to a postoperative mean of 88.4 points ( P < .01). No significant differences in shoulder ROM and functional scores were found between patients who received the classic vs congruent arc procedures. There were 5 recurrences (3.5%): 3 dislocations (2%) and 2 subluxations (1%). No significant difference in the recurrence rate was noted between groups. The bone block healed in 134 cases (92%). Conclusion: In athletes with recurrent anterior glenohumeral instability, the Latarjet procedure produced excellent functional outcomes. Most athletes returned to sports at their preinjury level, and the rate of recurrence was very low, regardless of whether the patients received surgery with the classic or congruent arc technique.

Parameters affecting postoperative success of surgery for stage 4A/4B ROP

2019 ◽  
Vol 103 (11) ◽  
pp. 1624-1632
Author(s):  
Cemal Özsaygili ◽  
Sengul Ozdek ◽  
Mehmet Cuneyt Ozmen ◽  
Hatice Tuba Atalay ◽  
Duygu Yalinbas Yeter
Keyword(s):  
Functional Results ◽  
First Year ◽  
Preoperative Treatment ◽  
Posterior Hyaloid ◽  
Retinal Tear ◽  
Stage 4 ◽  
The Mean ◽  
Second Year ◽  
Surgically Induced

PurposeTo describe the long-term anatomical and functional results of surgery for retinal detachment (RD) associated with stage 4 retinopathy of prematurity (ROP) and patient and surgery-related factors affecting postoperative success.DesignRetrospective case series at a single tertiary referral paediatric vitreoretinal practice.MethodsOne hundred and twenty-one eyes of 82 infants (40 female/42 male) who underwent lens-sparing vitrectomy (LSV) or lensectomy with vitrectomy surgery for stage 4A and 4B ROP at Gazi University Department of Ophthalmology between 2011 and 2016 were enrolled in this study. Patient characteristics including gestational age, birth weight, gender, stage of ROP at presentation, preoperative treatment (laser, anti-vascular endothelial growth factor (VEGF) or combined), anatomical and functional outcome and complications were recorded. The effect of birth weight, gestational age, presence of plus disease, preoperative treatment status, surgically induced posterior hyaloid detachment, postoperative vitreous haemorrhage and iatrogenic retinal tear formation on anatomical and functional results was evaluated.Results61.2% of the eyes were stage 4A and 38.8% were stage 4B ROP. The mean follow-up was 24.5 months. 18.2% of the eyes had no preoperative treatment. Anatomical success was 86.5% for stage 4A and 68.1% for stage 4B at the first year, 91.7% for stage 4A and 69.4% for stage 4B at the second year, and 95.8% for stage 4A and 57.9% for stage 4B at the third year. Functional success was 85.1% for stage 4A and 65.9% for stage 4B at the first year, 89.6% for stage 4A and 61.1% for stage 4B at the second year, and 87.5% for stage 4A and 57.8% for stage 4B at the third year. The mean visual acuity was 1.12±0.34 logarithm of the minimum angle of resolution (logMAR) for stage 4A and 1.34±0.32 logMAR at the 3-year follow-up duration (p>0.05). There was preoperative plus disease in 59.5% of the eyes. Subsequent retinal surgeries were required in 17.4% of the eyes. Presence of plus disease and absence of preoperative treatment, iatrogenic retinal tear formation and postoperative vitreous haemorrhage were found to have significant negative effects, while surgical induction of posterior hyaloid detachment and sparing the lens intraoperatively affected the anatomical and functional results positively.ConclusionsSurgery for stage 4 ROP-associated RD resulted in encouraging anatomical and functional outcomes and the results are even better in eyes with preoperative (laser/anti-VEGF) treatment, LSV and surgically induced posterior hyaloid detachment.

Long-Term Results After Policization for Congenital Hand Deformities

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 79-85 ◽  
Author(s):  
Toshihiko Ogino ◽  
Seiichi Ishii
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Pinch Strength ◽  
Cosmetic Results ◽  
Opposite Hand ◽  
Hand Deformities ◽  
The Mean ◽  
Congenital Hand Deformities

Thirteen patients — 18 hands — have been treated with pollicization and could be followed-up for 2 years to 19 years with an average of 7.9 years. Surgery was performed according to the Buck-Gramcko method. The mean age at the time of pollicization was 1.7 years. The parents were satisfied with the cosmetic results in all cases, and they were satisfied with the functional results in all except 4 hands. At follow-up, all patients could use the pollicized digit for pinch. Excellent pinch function has been achieved in 11 hands, good in 2, and fair in 1. The average percent pinch strength compared to the opposite hand was 55%. Association of a radial club hand and contracture of the pollicized digit and other fingers seemed to influence the postoperative pinch function.

scholarly journals Early Clinical Results of Arthroscopically Assisted Drilling via the Radius in a Distal-to-Proximal Direction for Osteochondritis Dissecans of the Elbow

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986893
Author(s):  
Yuji Arai ◽  
Kunio Hara ◽  
Hiroaki Inoue ◽  
Ginjiro Minami ◽  
Yoshikazu Kida ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Osteochondritis Dissecans ◽  
Japanese Orthopaedic Association ◽  
Case Series ◽  
Return To Sport ◽  
Functional Scores ◽  
Arthroscopically Assisted ◽  
The Mean ◽  
Flexion And Extension

Background: We have previously reported the technique of arthroscopically assisted drilling of osteochondritis dissecans (OCD) lesions of the elbow via the radius in a distal-to-proximal direction. With this technique, the entire OCD lesion can be drilled vertically under arthroscopic guidance with pronation and supination of the forearm and flexion and extension of the elbow joint. Purpose: To retrospectively evaluate return to sport, range of motion, and the Japanese Orthopaedic Association–Japan Elbow Society Elbow Function Score (JOA-JES score) after treatment of an elbow OCD lesion by drilling through the radius. Study Design: Case series; Level of evidence, 4. Methods: From November 2003 to January 2006, a total of 7 male adolescent baseball players with OCD lesions of the elbow were treated through use of arthroscopically assisted drilling via the radius. The stage of the OCD lesion was evaluated based on preoperative plain radiographs. Patients were observed for a minimum of 36 months, and clinical analysis included time for return to sport, elbow range of motion, and the JOA-JES score before intervention and at final follow-up. Results: We evaluated all 7 patients at a mean follow-up time of 36.1 months (range, 24-68 months). The stage of the OCD lesion on plain radiography was “translucent” in 1 patient, “sclerotic” in 5 patients, and “loosening” in 1 patient. The mean range of motion before surgery was 131.2° and –4.7° in flexion and extension, respectively, and this improved to 138.6° and 1.1° at final follow-up. The improvement in extension was statistically significant ( P = .04). The mean JOA-JES score of 83.0 before surgery significantly improved to 94.0 at final follow-up ( P < .001). One patient required excision of a free body at 51 months postoperatively, but all patients returned to sports early and without pain at an average of 4.6 months postoperatively. No feature of osteoarthrosis was noted on radiography on the final examination in any patient. Conclusion: The findings of this study demonstrate that arthroscopically assisted drilling of an elbow OCD lesion through the radial head allows for early return to sporting activities as well as improved motion and functional scores.

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