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Pediatric Elbow Arthroscopy: Indications and Complications
Steven M. Andelman, MD; Kristen M. Meier, MD, MS; Joung Heon Kim, BS1; William J Rubenstein, BS1; Michael R. Hausman, MD
Mount Sinai School of Medicine, New York, NY

Elbow arthroscopy is a safe and effective means by which to treat a variety of pathologic conditions of the elbow. While well described in the adult population, significantly less is known regarding the indications and safety of elbow arthroscopy in the pediatric patient. Previous publications have suggested the primary role for pediatric elbow arthroscopy is in the treatment of osteochondritis dessicans. We present a retrospective review of the indications and complications for pediatric elbow arthroscopy and demonstrate the increasing role of this minimally invasive technique in treating an expanding array of pediatric elbow pathology.

A retrospective review was performed of arthroscopic elbow surgeries on patients less than eighteen years old by a single surgeon at a single institution from 2001-2015. Standard and accepted arthroscopic techniques were utilized. The age at date of surgery, gender of patient, indication for surgery, and any associated complications were recorded.

55 arthroscopic elbow surgeries in 51 patients (51 elbows) were available for review. Table One provides an overview of the average age at time of surgery, indication for surgery, and associated surgical complications. The most common indications for intervention were arthroscopic contracture release for post-traumatic arthrofibrosis (26/55, 47.3%), arthroscopic-assisted closed reduction and percutaneous pinning for elbow fracture (10/55, 18.2%), arthroscopic treatment of osteochondritis dessicans (10/55, 18.2%), diagnostic arthroscopy for elbow instability (5/55, 9.1%), arthroscopic release for snapping plica (3/55, 5.5%), and arthroscopic debridement of the ulnohumeral joint (1/55, 1.8%). Four arthroscopic contracture releases were performed as staged, planned procedures in two patients (three in one patient, one in another). An overall complication rate of 20.0% (11/55) was identified, 7.3% (4/55) of which were categorized as minor complications while 12.7% (7/55) of which were categorized as major complications.

Discussion/Conclusion Elbow arthroscopy is a safe and minimally invasive surgical technique that can be utilized to treat an expanding array of elbow pathology in the pediatric population. While previous literature has suggested the primary role for pediatric elbow arthroscopy is in treatment of osteochondritis dessicans, we demonstrate the increasing role of arthroscopy in the treatment of post-traumatic arthrofibrosis, fracture fixation, and in the diagnosis and treatment of soft tissue pathology.

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