Long-term results of closed-wedge osteotomy of the lateral humeral condyle for osteochondritis dissecans of the capitellum

• Material Type: 博士論文
• Title: Long-term results of closed-wedge osteotomy of the lateral humeral condyle for osteochondritis dissecans of the capitellum
• Author/Editor: Koda, Hisao
• Publication Date: 2020-03-13
• Publication Date (W3CDTF): 2020-03-13
• Alternative Title: 上腕骨小頭離断性骨軟骨炎に対する上腕骨外側顆楔状骨切り術の長期成績
• Degree grantor/type: 新潟大学
• Date Granted: 2020-03-13
• Date Granted (W3CDTF): 2020-03-13
• Dissertation Number: 乙第2242号
• Degree Type: 博士(医学)
• Conferring No. (Dissertation): 乙第2242号
• Text Language Code: eng
• Subject Heading: Closed-wedge osteotomy; lateral humeral condyle; osteochondritis dissecans; capitellum; ICRS classification; baseball
• Note (General): Background: Various surgical methods are used for osteochondritis dissecans of the capitellum; however, we have consistently performed a closed-wedge osteotomy of the lateral humeral condyle since 1983. The purpose of this study is to clarify the long-term results of closed-wedge osteotomy for osteochondritis dissecans of the capitellum. Methods: Seventy-seven elbows with all lesion types of osteochondritis dissecans of the capitellum were treated with closed-wedge osteotomy. Unstable osteochondral fragments were fixed with a bone graft and bone pegs in combination with osteotomy. The mean age of the patients was 14.0 years. The patients were clinically and radiographically evaluated at a median value of 9.0 years after surgery. Results: The range of elbow motion and standard deviation were increased significantly from 119°± 22° preoperatively to 131°± 18° postoperatively (P < .001). The Timmerman and Andrews score were improved significantly from 141 ± 26 points preoperatively to 184 ± 21 points postoperatively (P < .001). The Timmerman and Andrews score and the range of elbow motion at final examination in patients with preoperative osteoarthritic changes were significantly inferior to those in patients without preoperative osteoarthritic changes. Good remodeling of the capitellar lesions was radiographically observed in 53 elbows (69%). In the long-term follow-up evaluation, although 41 elbows (53%) had advanced osteoarthritic changes that were classified as grade II or III, disease progression was controlled in most of these cases. Conclusions: Good or excellent long-term clinical results were maintained in most of our patients. Closed-wedge osteotomy of the lateral humeral condyle is a useful method that can provide acceptable long-term clinical results. Level of evidence: Level IV; Case Series; Treatment Study; Journal of Shoulder and Elbow Surgery. 2019, 28(9), e313-e320.; 新大博(医)乙第1813号; 元資料の権利情報 : 【○!C】 2019 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.
• DOI: info:doi/10.1016/j.jse.2019.05.016; https://doi.org/info:doi/10.1016/j.jse.2019.05.016
• Persistent ID (NDL): info:ndljp/pid/11570027; https://dl.ndl.go.jp/pid/11570027
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2020-11-10T19:58:22+09:00
• Date Created (W3CDTF): 2020-08-31
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
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• Periodical Title (URI): http://hdl.handle.net/10191/00051845
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp