Definition
Crushing AVN of capitellum
- 4 - 10 years
- maximum 14 years
- usually boys, baseball pitchers
Aetiology
Valgus compression
- i.e. baseball pitchers
Two forms
1. True Panner's / Crushing Osteochondritis
- young patient
2. OCD form in older boys
- older than 10
- loose bodies
- locking / catching symptoms
Clinical Features
Pain with throwing
- tender lateral aspect elbow
- FFD or lack of flexion
Xray
Panner's
- epiphysis condensed & fragmented
OCD
- localised area of AVN
MRI
Useful in grading OCD
Treatment
Panners
- usually reconstitutes without disability
- immobilise 4 weeks, NSAIDS
- avoid throwing for period
- gradual strengthening and return
- good prognosis
OCD
- grade and treat appropriately
- pin in situ if able
- remove loose bodies / microfracture
- arthroscopy
- prognosis much worse especially in competitive athlete
See Elbow / Capitellar OCD