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Panner's/OCD
Panner's & OCD Power Point
Question | Answer |
---|---|
Panner's | Osteochondrosis Degenerative necrosis followed by re-ossification of a primary or secondary growth center |
Panner's | Cased by abnormal compressive forces across radiocapitellar joint Boys <10 Unilateral presentation, usually dominant arm |
Presentation of Panner's | Pain/stiffness for several weeks; Accompanied with overuse or mild trauma; Pain worse with activity, better with rest; Loss of motion common (~20 deg from full ext) |
Panner's Treatment | Activity Modification; May require immobilization for a few weeks; S/sx may last several months, although long-term prognosis is excellent |
OD | Adolescents >10 yrs; Avg presentation age 12-17 yrs; Common in baseball, gymnastics & racquet sports |
OD | Compression lesion of radiocapitellar joint; Bony & articular injury to anterolateral capitellum; Leading cause of permanent elbow disability in young pitching athletes |
OD | Caused by repetitive chronic impact of radial head vs. capitellum during cocking & acceleration phase of throwing; Causes circulatory changes radiocapitellar joint; Aseptic necrosis of radial head |
OD Results in what? | Formation of loose bodies; Overgrowth of radial head; Early arthritic changes |
OD Symptoms | Insidious onset; Gradual hx of pain (worse with activity)-better with rest; Common tenderness over radiocapitellar joint; Crepitus with sup/pron |
OD Imaging | Radiographs show focal area of lucency in sub-chondral bone in anterior aspect of capitellum; Capitellar refraction, radiolucency or flattening of articular cartilage |
OD Treatment | Dependent on integrity of articular cartilage; Intact & stable can be treated conservatively; Activity modification 3-6 wks |
OD Treatment | After immobilization, motion can begin; When motion is full, begin isometrics; Ex's to lateral compartment must be limited; Gradual return to activity in 3-6 months |
OD Surgical Tx | Failed non-op tx; Loose bodies with mechanical symptoms or presence of unstable lesions; Surgery: drilling & fragment fixation |