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Early Lateral Compartment Physeal Closure of the Elbow in Osteochondritis Dissecans of the Adolescent Baseball Players
Korean J Sports Med 2018;36:180-188
Published online December 1, 2018;  https://doi.org/10.5763/kjsm.2018.36.4.180
© 2018 The Korean Society of Sports Medicine.

Jung Hoei Ku, Hyung Lae Cho, Ki Bong Park, Wan Seok Lee

Department of Orthopaedic Surgery, Good Samsun Hospital, Busan, Korea
Correspondence to: Ki Bong Park
Department of Orthopaedic Surgery, Good Samsun Hospital, 326 Gaya-daero, Sasang-gu, Busan 47007, Korea
Tel: +82-51-322-0900, Fax: +82-51-310-9348, E-mail: 214077@goodhospital.or.kr
Received September 7, 2018; Revised November 13, 2018; Accepted November 16, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: The purpose of this study is to identify bilateral differences of physeal closure of the lateral compartment of the elbow in osteochondritis dissecans (OCD) and related factors with premature physeal closure.
Methods: Initial radiographs of the bilateral elbows in 40 baseball players with OCD (group I) were reviewed for the status of physeal closure of the lateral compartment; capitellum, radial head, lateral epicondyle. Forty baseball players with medial epicondylar apophysitis (group II) were enrolled as a control. Relative status of physeal closure of dominant elbow was defined as early, same, and delayed. Bilateral differences of the status of physeal closure were analyzed between groups, and according to the radiographic stages, extent of the lesions and demographic factors in group I.
Results: Significant early physeal closures of dominant elbows were identified in group I in capitellum (group I, 55%; group II, 3%), radial head (group I, 53%; group II, 3%), and lateral epicondyle (group I 37%; group II, 5%). In group I, advanced stage and extended lesion showed early lateral compartment physeal closure especially in capitellum and radial head, and players with longer career length and limitation of motion showed early closure.
Conclusion: Over the half of the adolescent baseball players with OCD demonstrated early radiocapitellar physeal closures of dominant elbow in initial presentation. Because premature physeal closure contributes to the development of arthritis without appropriate radiocapitellar remodeling, early detection of OCD is essential for prevention of arthritis and successful conservative management.
Keywords : Adolescent baseball players, Osteochondritis dissecans, Premature physeal closure, Radiocapitellar arthritis
References
  1. Cain EL Jr, Dugas JR, Wolf RS, Andrews JR. Elbow injuries in throwing athletes: a current concepts review. Am J Sports Med 2003;31:621-35.
    Pubmed CrossRef
  2. Yadao MA, Field LD, Savoie FH 3rd. Osteochondritis dissecans of the elbow. Instr Course Lect 2004;53:599-606.
    Pubmed
  3. Ruchelsman DE, Hall MP, Youm T. Osteochondritis dissecans of the capitellum: current concepts. J Am Acad Orthop Surg 2010;18:557-67.
    Pubmed CrossRef
  4. Takahara M, Mura N, Sasaki J, Harada M, Ogino T. Classification, treatment, and outcome of osteochondritis dissecans of the humeral capitellum. J Bone Joint Surg Am 2007;89:1205-14.
    Pubmed CrossRef
  5. Mihara K, Tsutsui H, Nishinaka N, Yamaguchi K. Nonoperative treatment for osteochondritis dissecans of the capitellum. Am J Sports Med 2009;37:298-304.
    Pubmed CrossRef
  6. Mihata T, Quigley R, Robicheaux G, McGarry MH, Neo M, Lee TQ. Biomechanical characteristics of osteochondral defects of the humeral capitellum. Am J Sports Med 2013;41:1909-14.
    Pubmed CrossRef
  7. Wu M, Eisenberg K, Williams K, Bae DS. Radial head changes in osteochondritis dissecans of the humeral capitellum. Orthop J Sports Med 2018;6:2325967118769059.
    Pubmed KoreaMed CrossRef
  8. Caine D, DiFiori J, Maffulli N. Physeal injuries in children's and youth sports: reasons for concern? Br J Sports Med 2006;40:749-60.
    Pubmed KoreaMed CrossRef
  9. Sato T, Shinozaki T, Fukuda T, et al. Atypical growth plate closure: a possible chronic Salter and Harris type V injury. J Pediatr Orthop B 2002;11:155-8.
    Pubmed
  10. Minami M, Nakashita K, Ishii S, et al. Twenty-five cases of osteochondritis dissecans of the elbow. Rinsho Seikei Geka 1979;14:805-10.
  11. Kosaka M, Nakase J, Takahashi R, et al. Outcomes and failure factors in surgical treatment for osteochondritis dissecans of the capitellum. J Pediatr Orthop 2013;33:719-24.
    Pubmed CrossRef
  12. Takahara M, Ogino T, Sasaki I, Kato H, Minami A, Kaneda K. Long term outcome of osteochondritis dissecans of the humeral capitellum. Clin Orthop Relat Res 1999;(363):108-15.
    CrossRef
  13. Takahara M, Ogino T, Takagi M, Tsuchida H, Orui H, Nambu T. Natural progression of osteochondritis dissecans of the humeral capitellum: initial observations. Radiology 2000;216:207-12.
    Pubmed CrossRef
  14. Davies DA, Parsons FG. The age order of the appearance and union of the normal epiphyses as seen by X-rays. J Anat 1927;62(Pt 1):58-71.
    Pubmed KoreaMed
  15. Yamaguchi K, Sweet FA, Bindra R, Morrey BF, Gelberman RH. The extraosseous and intraosseous arterial anatomy of the adult elbow. J Bone Joint Surg Am 1997;79:1653-62.
    Pubmed CrossRef
  16. Schenck RC Jr, Athanasiou KA, Constantinides G, Gomez E. A biomechanical analysis of articular cartilage of the human elbow and a potential relationship to osteochondritis dissecans. Clin Orthop Relat Res 1994;(299):305-12.
    Pubmed CrossRef
  17. Keret D, Mendez AA, Harcke HT, MacEwen GD. Type V physeal injury: a case report. J Pediatr Orthop 1990;10:545-8.
    Pubmed CrossRef
  18. Matsui Y, Funakoshi T, Momma D, et al. Variation in stress distribution patterns across the radial head fovea in osteochondritis dissecans: predictive factors in radiographic findings. J Shoulder Elbow Surg 2018;27:923-30.
    Pubmed CrossRef
  19. Weinstein SL, Dolan LA. Proximal femoral growth disturbance in developmental dysplasia of the hip: what do we know? J Child Orthop 2018;12:331-41.
    Pubmed KoreaMed CrossRef
  20. Bowen JR, Schreiber FC, Foster BK, Wein BK. Premature femoral neck physeal closure in Perthes disease. Clin Orthop Relat Res 1982;(171):24-9.
    CrossRef
  21. Kida Y, Morihara T, Kotoura Y, et al. Prevalence and clinical characteristics of osteochondritis dissecans of the humeral capitellum among adolescent baseball players. Am J Sports Med 2014;42:1963-71.
    Pubmed CrossRef
  22. Matsuura T, Suzue N, Iwame T, Nishio S, Sairyo K. Prevalence of osteochondritis dissecans of the capitellum in young baseball players: results based on ultrasonographic findings. Orthop J Sports Med 2014;2:2325967114545298.
    Pubmed KoreaMed CrossRef
  23. Oh Y, Lee R, Kim HS. Evaluation of skeletal maturity score for Korean children and the standard for comparison of bone age and chronological age in normal children. J Pediatr Endocrinol Metab 2012;25:279-84.
    Pubmed CrossRef