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Panner's & OCD Power Point

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
Created by: 1190550002



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