Posterior Elbow Problems in the Overhead Athlete

Characteristics of injuries related to Kin-Ball sport in Japan: A questionnaire study

INTRODUCTION

The number of Kin-Ball sport participants is expected to increase in the future. However, there is no report on the characteristics of the injuries associated with Kin-Ball sport.

OBJECTIVE

The purpose of this study was to describe the characteristics of injuries relate to Kin-Ball sport.

DESIGN

Observational study.

SETTING

A self-administered questionnaire was used for data collection.

PARTICIPANTS

One hundred ninety Kin-Ball sport participants were included in this study.

MAIN OUTCOME MEASURES

The questionnaire was designed based on physical characteristics, participation in Kin-Ball sport, and Kin-Ball sport injuries. Participation in Kin-Ball sport includes the length of time spent playing Kin-Ball sport as well as the playing categories (junior, friendly, champion challenge, champion, over 40). Kin-Ball sport injuries include the presence or absence of injury experience, the site, type, situation, and current injuries or pain associated with Kin-Ball sport.

RESULTS

One hundred fifty-two players (80%) of Kin-Ball sport participants were injured. The ankle was the most frequently visited body site (60; 22.1%), and the elbow was the second most visited body site (40; 14.8%). Sprains were the most common type of injury.

CONCLUSION

This is the first study to describe the characteristics of injuries relate to Kin-Ball sport. The findings of this study could be beneficial for athletes, coaches, trainers, and clinicians to prevent, or treatment of the injuries.

Elbow Arthroscopy for Posteromedial Impingement and Fixation of Olecranon Stress Fracture

Posteromedial elbow impingement due to valgus extension overload often develops as a result of excessive valgus and extension force during repetitive overhead throwing activities. Impingement classically occurs in throwing athletes such as baseball, tennis, softball, or lacrosse players. If isolated, arthroscopic removal of the posteromedial olecranon osteophytes shows excellent postoperative satisfaction, return to sport rates, and return to previous level of activity. This Technical Note describes treatment of posteromedial elbow impingement syndrome and associated olecranon stress fracture treated with arthroscopic removal of posteromedial osteophytes and arthroscopic-assisted screw fixation.

Acute and overuse elbow trauma: radio-orthopaedics overview

The correct management of acute, subacute and overuse-related elbow pathologies represents a challenging diagnostic and therapeutic problem. While major trauma frequently requires a rapid surgical intervention, subluxation and minor trauma allow taking more time for diagnostics and planning the correct elective treatment after careful clinical and radiological investigation. In these conditions, communication between orthopaedic surgeon and radiologist allow to create a detailed radiology report, tailored to the patient's and surgeon's needs and optimal to plan proper management. Imaging technique as X-Ray, CT, US, MRI, CTA and MRA all belong to the radiologist's portfolio in elbow diagnostics. Detailed knowledge of elbow pathology and its classification and of the possibilities and limits of each imaging technique is of crucial importance to reach the correct diagnosis efficiently. The aim of this review is to present the most frequent elbow pathologies and suggest a suitable diagnostic approach for each of them.

Prevalence of posterior elbow problems in Japanese high school baseball players

BACKGROUND

Various posterior elbow problems cause posterior elbow pain among baseball players. We aimed to determine the prevalence and diagnoses associated with posterior elbow problems and post-treatment recovery time for returning to sports in Japanese high school baseball players when treated in the off-season.

METHODS

A total of 576 Japanese high school baseball players who participated in baseball skill training camp during the off-season were enrolled in the study. The elbow of each player's throwing arm was assessed by use of a questionnaire and physical examination. Players with abnormal results were advised to visit the hospital. Players who visited the hospital were initially treated conservatively and underwent surgery if necessary. Retrospectively, players with positive physical examination results associated with posterior elbow pain, defined as olecranon tenderness and/or a positive elbow extension impingement test, were selected. Information about their position, elbow pain, physical examination results, diagnosis, treatment, and recovery time before returning to playing sports was assessed.

RESULTS

Olecranon tenderness and/or positive elbow extension impingement test results were found in 76 players (13.2%). Of these, 33 agreed to visit the hospital for further diagnostic imaging and 25 players (75.8%) were diagnosed with posteromedial elbow impingement. By the next spring, 87.9% of players returned to sport, and 100% of players returned to sport before the next summer. The average recovery period was 77 ± 47 days.

CONCLUSION

Physical examinations related to posterior elbow injuries were positive in 13.2% of high school baseball players. The most common diagnosis for posterior elbow pain was posteromedial elbow impingement. All players returned to competitive sports activity levels within 77 ± 47 days.

Pitcher's elbow: medial elbow pain in the overhead-throwing athlete

Overhead athletes subject their elbows to significant valgus stresses throughout the throwing cycle. A steady rise in the number of medial-sided elbow injuries over the years has lead to increased awareness regarding the pathophysiology of the "pitcher's elbow." As our understanding of the functional anatomy and throwing biomechanics has become more sophisticated, we have seen a concurrent improvement in the outcomes associated with managing these injuries. Despite this improvement, continued anatomical and biomechanical research is still needed to further optimize outcomes and return to sport.

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

BACKGROUND

The radiographic appearance of osteochondritis dissecans (OCD) of the humeral capitellum varies according to the stage of the lesion. It is important to evaluate the stage of OCD lesion carefully to guide treatment. We compared the interobserver reliability of currently used classification systems for OCD of the humeral capitellum to identify the most reliable classification system.

METHODS

Thirty-two musculoskeletal radiologists and orthopaedic surgeons specialized in elbow surgery from several countries evaluated anteroposterior and lateral radiographs and corresponding computed tomography (CT) scans of 22 patients to classify the stage of OCD of the humeral capitellum according to the classification systems developed by (1) Minami, (2) Berndt and Harty, (3) Ferkel and Sgaglione, and (4) Anderson on a Web-based study platform including a Digital Imaging and Communications in Medicine viewer. Magnetic resonance imaging was not evaluated as part of this study. We measured agreement among observers using the Siegel and Castellan multirater κ.

RESULTS

All OCD classification systems, except for Berndt and Harty, which had poor agreement among observers (κ = 0.20), had fair interobserver agreement: κ was 0.27 for the Minami, 0.23 for Anderson, and 0.22 for Ferkel and Sgaglione classifications. The Minami Classification was significantly more reliable than the other classifications (P < .001).

CONCLUSIONS

The Minami Classification was the most reliable for classifying different stages of OCD of the humeral capitellum. However, it is unclear whether radiographic evidence of OCD of the humeral capitellum, as categorized by the Minami Classification, guides treatment in clinical practice as a result of this fair agreement.