[Aseptic necroses and osteochondrosis dissecans of the elbow joint]

In our opinion, complete (Panner's disease) and incomplete (osteochondrosis dissecans; OD) necrosis of the elbow epiphysis form a nosologic unit. A review of the localization, pathogenetic hypotheses, symptoms, diagnosis and treatment of aseptic necrosis and OD of the elbow is presented with reference to the older and, especially, the current literature. In contrast to the procedures reported in the literature, we performed subchondral focus drilling in 10 patients over 10 years of age suffering from Panner's disease, with good functional results. Operative therapy was performed on 50 elbow affected by OD. Follow-up examinations were possible in 35, with an average observation period of 94.3 months. The results are categorized according to the stage of disease before treatment. It is desirable to perform surgical treatment at an early stage of the disease, since this can make it possible to avoid dissection. If dissecion is present, refixation early in the middle stage seems to be the treatment of choice.