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Background: Costal osteochondral grafting is a technique to achieve anatomical and biological repair of articular defects. Some small series of clinical applications of this procedure for advanced osteochondritis dissecans of the humeral capitellum, with short-term follow-up, have been reported; however, longer-term outcomes remain unclear. The purpose of this study was to clarify longer-term clinical outcomes of costal osteochondral autografts in the treatment of advanced osteochondritis dissecans of the humeral capitellum.Methods: Seventy-two patients with an osteochondral defect of the humeral capitellum were treated with costal osteochondral autograft and followed for a minimum of 3 years (mean follow-up, 57 months; range, 36 to 147 months). The mean patient age was 14.3 years. Clinical outcomes, including elbow range of motion, Timmerman and Andrews clinical rating score, donor-site morbidity, responses to a questionnaire regarding a return to sporting activities, and radiographic findings, were evaluated.Results: The mean elbow range of extension/flexion increased significantly, from -21°/122° preoperatively to -4°/136° postoperatively (p < 0.001). The mean clinical rating score improved significantly, from 101 to 190 by the latest follow-up (p < 0.001). The overall clinical score-based assessment was excellent for 60 patients, good for 9, and fair for 3. Seventy of the 72 patients returned to their original sport. The remaining 2 patients had changed sporting activities before surgery and did not return to baseball, despite satisfactory clinical results.Conclusions: Costal osteochondral autograft successfully achieved anatomical and biological reconstruction in the treatment of advanced osteochondritis dissecans of the humeral capitellum.Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Case: While working in a factory, a thirty-five-year-old man injured his right forearm and was then diagnosed with acute compartment syndrome. Ruptures of the flexor and extensor tendons were revealed via single volar and dorsal incisions. End-to-side transfer with use of the remaining extensor tendons was performed; the end of the extensor indicis proprius tendon was sutured to the side of the extensor digitorum communis tendon of the middle finger, and the extensor pollicis longus tendon was sutured to the extensor pollicis brevis tendon. Conclusion: In cases of high-energy injuries, associated tendon rupture should be considered. [ABSTRACT FROM AUTHOR]