Lateral Closing Wedge Osteotomy of Humerus for Osteochondritis Dissecans of the Capitellum

Osteochondritis dissecans of the Numeral capitellum is not uncommon in boys who have played baseball rigorously from a very young age. We report the surgical results of the lateral closing wedge osteotomy of the humerus first reported by Yoshizu. All 9 boys complained of elbow pain on throwing and batting, tenderness on lateral humeral condyle, and limited elbow motion. They needed to stop playing baseball or reduce their activity because of the pain. Separated (7) or freed (2) fragments from the capitellum were seen by radiogram in all boys. These boys were observed under conservative treatment for at least one month. The age at surgery ranged from 13 to 16 (mean; 14.8) years old. An osteotomy was performed to remove laterally based wedge bones which had a peak located at the junction between the capitellum and trochlea, and a peak angle was 10 degrees. In 7 of 9 boys, cancellous bones were grafted, and in 5 of the 9 boys, bone pegs were inserted to fix the fragments. The follow-up ranged from 9 to 105 months (mean 38 months). After the surgery, the pain was reduced or disappeared in all boys. The mean range of motion of the elbow joint did not change significantly after the surgery. Six to 8 months after the surgery, eight of the boys could play baseball as well as they could before developing the problem.