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Severe limitation of motion caused by a deformity and migration of the radial head after early surgical intervention for osteochondritis dissecans in a juvenile baseball player
Arthrosc Orthop Sports Med 2022;9:29-33
Published online May 1, 2022;  https://doi.org/10.14517/aosm22006
© 2022 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Tae Hong Kee, In-Ho Jeon, Kyoung Hwan Koh

Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence to: Kyoung Hwan Koh, https://orcid.org/0000-0002-6181-9621
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3322, Fax: +82-2-488-7877, E-mail: osdoc.koh@gmail.com
Received March 29, 2022; Revised April 29, 2022; Accepted May 3, 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
We describe a case of a 15-year-old baseball player with osteochondritis dissecans who underwent arthroscopic micro-fracture at a private clinic and present the consequent complications. Moreover, we describe the further treatment he underwent as well as provide surgical tips based on our experience with this case. The patient experienced limitation of motion and pain after the arthroscopic surgery at the private clinic and visited our hospital for revision surgery. We conducted an autogenous osteochondral graft transplantation; however, the graft collapsed and was displaced. This graft failure is presumed to be caused by the inadequate reduction of the radial head, resulting in an insufficient control of compressive force to the graft. This led to inadequate recovery of the limitation of motion, which was caused by the impingement of the deformed distal humeral structures. In conclusion, to successfully transplant an osteochondral graft, the compressive force must be sufficiently relived by adequately reducing the radial head, osteocapsular arthroplasty must be conducted to restore the normal structure and regain normal range of motion, and an allograft must be used instead of a costal autograft to overcome the compressive force.
Keywords : Juvenile osteochondritis dissecans; Early surgical intervention; Complication; Limitation of motion; Deformity
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