Osteochondrosis of the humeral capitellum

Abstract

Seven cases of osteochondrosis of the capitellum occurring in five high performance female gymnasts between the ages of 11 and 13 are presented. Two of the patients were treated by surgical excision of the loose osteochondral fragment in three elbows. Four of the five gymnasts, including the two who underwent surgical treatment, were able to return to full workouts without recurrence of symptoms within the 3 year followup. All conditions in gymnasts were detected after symptoms had presented. A survey of 37 actively competing gymnasts at a nationally known gymnastics academy was performed, including a detailed history and physical examination and radiographic examination. No other cases of osteochondrosis were detected. It was postulated that this condition represents a lateral compression injury because of repetitive valgus overload. Investigation of the capitellar blood supply indicates that the common factors in osteochondrosis of the capitellum are repetitive or prolonged trauma to a vulnerable epiphysis on a basis of vascular interruption. Gymnastics maneuvers require forceful weight-bearing through the upper extremities. Medical personnel and coaches associated with gymnastics need to be aware of the condition of osteochondrosis of the capitellum so that any gymnast who presents with a painful, tender, swollen or locked elbow is appropriately investigated and treated.