Panner's Disease

Definition

 

Crushing AVN of capitellum

- 4 - 10 years

- maximum 14 years

- usually boys, baseball pitchers

 

Aetiology

 

Valgus compression

- i.e. baseball pitchers

 

Two forms

 

1.  True Panner's / Crushing Osteochondritis

- young patient

 

2. OCD form in older boys

- older than 10

- loose bodies

- locking / catching symptoms

 

Clinical Features

 

Pain with throwing

- tender lateral aspect elbow

- FFD or lack of flexion

 

Xray

 

Panner's

- epiphysis condensed & fragmented

 

OCD

- localised area of AVN

 

MRI

 

Useful in grading OCD

 

Treatment

 

Panners

- usually reconstitutes without disability 

- immobilise 4 weeks, NSAIDS

- avoid throwing for period

- gradual strengthening and return

- good prognosis

 

OCD

- grade and treat appropriately

- pin in situ if able

- remove loose bodies / microfracture

- arthroscopy

- prognosis much worse especially in competitive athlete

 

See Elbow / Capitellar OCD