Elbow Injuries in the Adolescent Thrower

被引:8
作者
Griffith T.B. [1 ]
Kercher J. [1 ]
Clifton Willimon S. [2 ]
Perkins C. [2 ]
Duralde X.A. [1 ]
机构
[1] Peachtree Orthopedics, Atlanta, GA
[2] Children’s Hospital of Atlanta, Atlanta, GA
关键词
Adolescent elbow injuries; Elbow osteochondritis dissecans; Medial epicondyle fracture; Olecranon stress fractures; Persistent olecranon physis; Ulnar collateral ligament repair;
D O I
10.1007/s12178-018-9457-4
中图分类号
学科分类号
摘要
Purpose of Review: With an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures. Recent Findings: Acceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve. Unstable osteochondritis dissecans lesions, especially in patients with closed growth plates, require operative fixation, and emerging open and arthroscopic techniques including lesion debridement, marrow stimulation, autograft transfer, and allograft transplantation are described with good outcomes. Ulnar collateral repair has emerged as an exciting treatment option for an avulsion of either end of the ligament in young throwing athletes, with faster rehabilitation times than traditional ulnar collateral ligament reconstruction. Olecranon stress fractures are increasing in prevalence, and when a non-operative treatment course is unsuccessful, athletes have a high return-to-play rate after percutaneous cannulated screw placement. Summary: With proper indications, non-operative and operative treatment modalities are reported with a high return-to-play and acceptable clinical outcomes for common elbow injuries, including medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures, in adolescent throwing athletes. Further research is needed to better define treatment algorithms, surgical indications, and outcomes. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
引用
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页码:35 / 47
页数:12
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共 79 条
  • [1] Gottschalk H.P., Eisner E., Hosalkar H.S., Medial epicondyle fractures in the pediatric population, J Am Acad Orthop Surg, 20, 4, pp. 223-232, (2012)
  • [2] Patel B., Reed M., Patel S., Gender-specific pattern differences of the ossification centers in the pediatric elbow, Pediatr Radiol, 39, 3, pp. 226-231, (2009)
  • [3] Gottschalk H.P., Bastrom T.P., Edmonds E.W., Reliability of internal oblique elbow radiographs for measuring displacement of medial epicondyle humerus fractures: a cadaveric study, J Pediatr Orthop, 33, 1, pp. 26-31, (2013)
  • [4] Fowles J.V., Slimane N., Kassab M.T., Elbow dislocation with avulsion of the medial humeral epicondyle, J Bone Joint Surg Br, 72, 1, pp. 102-104, (1990)
  • [5] Josefsson P.O., Danielsson L.G., Epicondylar elbow fracture in children. 35-year follow-up of 56 unreduced cases, Acta Orthop Scand, 57, 4, pp. 313-315, (1986)
  • [6] Louahem D.M., Bourelle S., Buscayret F., Mazeau P., Kelly P., Dimeglio A., Cottalorda J., Displaced medial epicondyle fractures of the humerus: surgical treatment and results. A report of 139 cases, Arch Orthop Trauma Surg, 130, 5, pp. 649-655, (2010)
  • [7] Farsetti P., Potenza V., Caterini R., Ippolito E., Long-term results of treatment of fractures of the medial humeral epicondyle in children, J Bone Joint Surg Am, 83-A, 9, pp. 1299-1305, (2001)
  • [8] Knapik D.M., Fausett C.L., Gilmore A., Liu R.W., Outcomes of nonoperative pediatric medial humeral epicondyle fractures with and without associated elbow dislocation, J Pediatr Orthop, 37, 4, pp. e224-e228, (2017)
  • [9] Lee H.H., Shen H.C., Chang J.H., Lee C.H., Wu S.S., Operative treatment of displaced medial epicondyle fractures in children and adolescents, J Shoulder Elb Surg, 14, 2, pp. 178-185, (2005)
  • [10] Pace G.I., Hennrikus W.L., Fixation of displaced medial epicondyle fractures in adolescents, J Pediatr Orthop, 37, 2, pp. e80-e82, (2017)