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rest and repeat examination and radiographs until complete healing occurs.
24%
218/916
rest and resumption of play when he is asymptomatic and examination shows restoration of painless range of motion.
65%
592/916
arthroscopic in situ drilling.
6%
56/916
arthroscopic drilling and internal fixation.
3%
30/916
arthroscopy with removal of the loose body, followed by lateral column osteotomy.
1%
11/916
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Osteochondritis of the capitellum is a common problem in young throwing athletes and gymnasts. The mechanism of injury involves lateral compression and axial loading of the capitellum. Repetitive trauma causes ischemia with resultant osteochondral necrosis and sometimes eventual separation. Initial management includes rest for a minimum of 6 weeks; occasionally bracing is used. At long-term follow-up, there is typically an observed radiographic abnormality indicating incomplete healing even in asymptomatic patients. Arthroscopy with in situ drilling is reserved for symptomatic lesions that have an intact articular surface. Lesions with partial separation often require fixation. Lateral column osteotomy is a new investigational procedure designed to relieve lateral compression forces and may be used in salvage cases.
2.7
(16)
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