First 50 Pediatric and Adolescent Elbow Arthroscopies: Analysis of Indications and Complications.

BACKGROUND

Elbow arthroscopy is a challenging, yet extremely productive procedure in orthopaedic sports medicine. The severely confined anatomy of the pediatric and adolescent elbow is particularly prone for perioperative complications. This study focuses on the indications and complications of the first 50 elbow arthroscopies in skeletally immature patients done in a specialized pediatric orthopaedic department.

PURPOSE: To review analysis of indications and complications in pediatric and adolescent elbow arthroscopy. We hypothesized that the complication rate in these patients is similar to adults.

METHODS

Data on 50 consecutive elbow arthroscopies were prospectively gathered in a dedicated database and retrospectively analyzed for indications and perioperative complications. All procedures were performed by a surgeon trained in orthopaedic sports medicine.

RESULTS

A total of 26 boys and 24 girls with a mean age of 13.6±3.3 years at the time of surgery and a minimum follow-up of 1 year were included.Fifty-eight percent were treated for osteochondritis dissecans, 24% for arthrofibrosis, 14% for a congenital disorder, and 4% for a posttraumatic problem other than arthrofibrosis. The complication rate was 8%, including 3 cases of transient neuropraxia and 1 superficial wound infection. There were no major complications such as septic arthritis, vascular injury, or permanent nerve damage. All complications resolved fully with conservative treatment, no revision were required.

DISCUSSION: Although osteochondritis dissecans is still the leading reason for such surgery, fractures and posttraumatic conditions are becoming more important. With a rate of 5% to 8% of minor, fully resolving complications such an increase is not a reason for concerns.

LEVEL OF EVIDENCE: Level IV-case series.