When the chondral lesion is assumed at the weight bearing area of the medial or lateral femoral condyle, the anterior portion of the sulcus terminalis (the groove for meniscus) in the middle section of the lateral condyle is considered to be the optimal donor site.
Subcutaneous release of the tendon sheath has been performed in 210 trigger digits of 172 patients. The follow-up period ranged from 3 to 58 months, with an average of 24 months. Based on our points system, the overall results were as follows: excellent 64.3%, good 9.5% fair 8.1%, poor 18.1%. There were no infections, no injuries of nerves or vessels and no functional insufficiency. This subcutaneous procedure can be easily, quickly and safely performed by careful hand surgeons in the out-patient clinic.
Stress fractures of the olecranon caused by repetitive stress force have infrequently been reported as a cause of elbow pain in adult athletes, engaged in throwing and pitching sports. We diagnosed as a stress fracture of the olecranon by clinical and radiographic findings and treated surgically. The patient returned to playing baseball at a competitive level and was asymptomatic 4 months after the first operation. However, the patient re-injured the olecranon and a second surgical treatment was performed almost 1 year after the first operation. After the second surgery, the patient returned to playing baseball at a competitive level and was free from elbow symptoms. We presented a stress fracture of the olecranon in a semi-professional adult baseball player and suggested that surgical treatment is necessary.
The present study is a report of retrospective case series of stress fracture of the olecranon. Six patients presented posterior elbow pain in throwing in baseball and softball, but fracture was not diagnosed in radiographs. We detected stress fracture of the olecranon using computed tomographic (CT) scan and treated the patient with internal fixation with a headless cannulated double threaded screw through a small skin incision. All patients returned to competitive level without elbow complaints after the operation.When throwing athletes present with unusual posterior elbow pain and no significant findings on radiographs, a CT scan examination should be performed. We recommend surgical treatment of internal fixation with a screw through a small skin incision, as a good option for stress fracture of the olecranon in order to allow early return to sports activity in competitive athletes.
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